Soft Tissue Sarcoma Resection Leads to Perforated Colon, Sepsis and Death

This case involves a male who underwent a procedure to remove a soft tissue sarcoma from the retroperitoneal region. The procedure was noted to be a success and was conducted without incident. Approximately twenty-four to forty-eight hours after the surgery, however, the patient started to develop signs and symptoms consistent with sepsis. A second procedure revealed that there were two puncture holes that perforated the colon and a delay to identify and repair these injuries allowed the patient to deteriorate rapidly. The patient was in the intensive care unit but died one month later after fighting the severe infection and its effects on the other body organs.

Question(s) For Expert Witness

Was this procedure conducted within the standard of care?

Expert Witness Response E-005040

Liposarcomas are the most common soft tissue sarcomas in adults but occurrence in the gastrointestinal tract is extremely rare. The clinical presentation of these tumors is frequently non-specific and commonest symptoms are generalised, intermittent abdominal pain. Surgical resection with clear margins is the treatment of choice for primary liposarcomas. They are moderately radiosensitive and chemotherapy is non-effective. Although gastrointestinal liposarcomas have been previously reported, this is the first case that I’ve heard where a primary liposarcoma is associated with a bowel perforation. This would lead me to believe that the bowel perforation was attributed to surgeon error and not an invasion of the tumor into the surrounding intestinal tissue.