Perforated colon cancer mimicking contaminated pancreatic pseudocyst: The treatment dilemma under urgent laparotomy

Abstract

SUMMARY
Non-traumatic colon perforation may be the result of an
advanced carcinoma, diverticulitis or inflammatory bowel
disease. Such perforations are rarely observed in the splenic
flexure and in special cases mimic pancreatic pseudocysts
or abscesses. On the other hand colonic perforation is an
uncommon but potentially lethal complication of a
pancreatic abscess. Several diagnostic and treatment
dilemmas the surgeon has to face as soon as the diagnosis
of a splenic flexure abscess has been made are: Is the
pancreas or the colon the origin of this lesion? Should
endoscopic drainage or operation be performed? And if
operation, what kind in such a critically ill patient? Here
we report a new case of a perforated colon cancer located in
the splenic flexure and mimicking a peripancreatic abscess
which was initially misinterpreted as a contaminated
pancreatic pseudocyst.