Case Report: Sigmoido-Uterine Fistula Caused by Ovarian Cancer Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Tuesday, November 08, 2016

Case Report: Sigmoido-Uterine Fistula Caused by Ovarian Cancer

 Hyperamylasemia may be described as an excess of the pancreatic enzyme - amylase in the blood. Digestion of your dietary intake of carbohydrates and fat relies on the action of amylase, found in the saliva, to begin the digestion of starches.
Amylase helps your body break down starch. Lipase helps your body digest fats. The pancreas, a glandular organ that sits behind the stomach, produces both of these enzymes. Inflammation of the pancreas, also called pancreatitis, commonly causes high levels of amylase and lipase in the bloodstream.
Hyperpyrexia is a fever with an extreme elevation of body temperature greater than or equal to 41.5 °C (106.7 °F).

 A 67-year-old woman presented with abdominal distension and difficulty in defecation. She had a huge mass in the left lower abdomen and hyperamylasemia with normal pancreatic-type amylase (P-AMY). Nuclear magnetic resonance and computed tomography scan revealed a huge pelvic mass, but the origin of mass wasn’t certain. After discussion with the multidisciplinary team, ultrasonography guided pathological biopsy of the mass was done. Pathological biopsy showed that the mass was poorly differentiated adenocarcinoma, which may be originated from ovary. Patient was on neo-adjuvant chemotherapy. After one and a half months of chemo-therapy, the patient developed colorectal-reproductive system fistula with hyperpyrexia. Laparatomy with resection of mass, sigmoid colon, left ovary and part of uterus, proximal colostomy with closure of the distal rectum and end to end anastomosis of left ureter with DJ tube drainage (left ureter invaded by tumor confirmed intra operation) was done.
Operative finding: Fistula between sigmoid colon and uterus through the tumor. To our knowledge, this is the first case report of patient with sigmoido-uterine fistula caused by ovarian cancer.


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