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. 2013 Feb;20(1):e44-7.
doi: 10.3747/co.20.1196.

Conservative management for an entero-adnexal fistula at initial presentation of advanced ovarian carcinoma

A Shai  1 , E Grikshtas, Y Segev, M Moskovitz, A Bitterman, M Steiner, O Lavie
Affiliations

Conservative management for an entero-adnexal fistula at initial presentation of advanced ovarian carcinoma

A Shai et al. Curr Oncol. 2013 Feb.

Abstract

Gastrointestinal fistulae can occur in ovarian cancer patients, usually in the setting of advanced relapsed disease. Treatment typically involves immediate surgery.Here, we describe a case of an abscess resulting from an intestinal fistula as the first manifestation of advanced epithelial ovarian cancer, and we review the current literature on this subject. The patient was successfully treated with a combination of chemotherapy, antibiotics, and delayed surgery. Optimal debulking was achieved without a need for bowel resection.This report is the first of conservative management of a fistula in an ovarian cancer patient in the chemotherapy-naïve setting.

Keywords: Fistula; abscess; chemotherapy; ovarian cancer; serous.

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Figures

FIGURE 1
FIGURE 1
Computed tomography image demonstrating an air–fluid level within an adnexal mass.
FIGURE 2
FIGURE 2
Computed tomography image demonstrating a reduction in the diameter of the adnexal mass and less air within the mass after 6 courses of chemotherapy.
FIGURE 3
FIGURE 3
Surgical specimen consisting of a mass containing malodorous fluid. Culture of the fluid revealed prominent growth of Escherichia coli.
See this image and copyright information in PMC

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