The patient underwent extended cholecystectomy, segmental resection, and anastomosis of the
transverse colon because of direct invasion of the
transverse colon by the tumor.
The primary tumor was located in 18.8% (6) of the patients in the right colon, 25% (8) in the left colon, 3.1% (1) in the
transverse colon, and 53.1% (18) in the rectum.
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Transverse colon and sigmoid colon are more vulnerable due to their mobility.
It can be seen most commonly in the sigmoid colon, less frequently in the cecum, descending colon and
transverse colon. Chronic constipation, varios abdominal masses, previous abdominal surgery, abnormal mobilization of the cecum and paralytic ileus were reported as etiologic and predisposing factors.
Surgical Resection of Locally Advanced Primary
Transverse Colon Cancer-Not a Worse Outcome in Stage II Tumor.
Motson said that do not open as
transverse colon will take more time as it is more difficult.
Eleven (21%) patients had tumors located in the cecum, ten (19%) had tumors located in the ascending colon, three (6%) had tumors located in the hepatic flexure, nine (17%) had tumors located in the
transverse colon, three (6%) had tumors located at the splenic flexure, three (6%) had tumors located in the descending colon, and fourteen (26%) had tumors located in the sigmoid colon.
The omentum and the
transverse colon were adherent to the gallbladder, and a fistula formation was observed between the
transverse colon and the gallbladder (Mirizzi syndrome, type 5).
Abdominal contrast-enhanced computed tomography (CECT) revealed a heterogeneous hyperechoic mass compressing the distal
transverse colon externally, suggesting the presence of a foreign body or tumor (Figure 1).
Upon colonoscopy, a 2 cm pedunculated polyp was identified in the
transverse colon. It was removed with a snare and clipped at the base.
During initial laparoscopic exploration, it was noted that the colon was no longer interposed above the liver, and the only abnormal gross finding was a very redundant proximal
transverse colon which could easily be maneuvered into the configuration noted on her CT scan.
Throughout the literature search, we came across 2 cases of
transverse colon cancers with metastasis to gallbladder masquerading as cholecystitis [4, 5].