Sepsis de foco abdominal secundario a microfístula tumoral de colon sigmoides. Reporte de caso

Abstract

Background: Sepsis is a worldwide priority, affecting all age groups and races, so it is important to know it accurately to reduce incidence and mortality. It is worth noting that oncology patients are at higher risk due to their immunosuppression caused by the side effect of chemotherapy in solid tumors and as the natural course of the disease in hematologic neoplasms. Case description: A fifty-one-year-old female patient of mixed race has recurrent urinary tract infections and is refractory to treatment. She complains of stabbing pain radiating from the vagina to the umbilicus when the bladder is distended and therefore visits the urology department. An imaging study revealed a mass in the sigmoid colon, prompting a colonoscopy and biopsy request, which revealed moderately differentiated adenocarcinoma with infiltration of the bladder and abdominal wall, with a classification of T4BN1M0. Days later and without neoadjuvant treatment, the patient presented pain and erythema in the hypogastrium, fever, tachycardia, and hypotension, and was admitted for supervision, where it was concluded that by micro-fistulas produced by a solid tumor caused sepsis. Conclusion: Sepsis of an abdominal focus secondary to tumor micro-fistula may develop unconventionally, with evidence of origin in histopathology, where micro-fistulas from the tumor to the abdominal wall have been reported. Because of the susceptibility of oncologic patients, caution should be exercised when performing procedures, as they can develop sepsis unconventionally due to their underlying pathology.