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Surgery Today

, Volume 38, Issue 2, pp 178–183 | Cite as

Colonic fistula associated with severe acute pancreatitis: Report of two cases

  • Atsushi Suzuki
  • Shohachi Suzuki
  • Takanori Sakaguchi
  • Kosuke Oishi
  • Kazuhiko Fukumoto
  • Shigeyasu Ota
  • Keisuke Inaba
  • Yasuo Takehara
  • Haruhiko Sugimura
  • Takashi Uchiyama
  • Hiroyuki Konno
Case Report

Abstract

Colonic fistula is a rare and potentially critical sequela of severe acute pancreatitis, which requires surgical treatment. We report two cases that were successfully treated by a colectomy for colonic fistula associated with severe acute pancreatitis. Case 1 is a 71-year-old man infected with pseudocysts owing to severe acute pancreatitis that developed into a colonic fistula as an early complication with a resulting pancreatic abscess. This patient underwent a left hemicolectomy, a transverse colostomy, and drainage of the pancreatic abscess. He has done well without recurrent disease for 35 months following surgery. Case 2 is a 58-year-old woman who had a past history of drainage during a laparotomy for a pancreatic abscess induced by endoscopic retrograde cholangiopancreatography 10 years earlier. She was admitted to our hospital with left lateral abdominal pain and low-grade fever. Abdominal magnetic resonance imaging showed a retroperitoneal abscess and fistula to the descending colon. She underwent a left hemicolectomy and drainage of the retroperitoneal abscess. She has remained symptom-free for 20 months following surgery. The colonic fistula should therefore be recognized as a late complication during long-term follow-up as well as an early sequela associated with severe acute pancreatitis.

Key words

Acute pancreatitis Colonic fistula Pancreatic pseudocyst Pancreatic abscess Endoscopic retrograde cholangiopancreatography 

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Copyright information

© Springer 2008

Authors and Affiliations

  • Atsushi Suzuki
    • 1
  • Shohachi Suzuki
    • 1
  • Takanori Sakaguchi
    • 1
  • Kosuke Oishi
    • 1
  • Kazuhiko Fukumoto
    • 1
  • Shigeyasu Ota
    • 1
  • Keisuke Inaba
    • 1
  • Yasuo Takehara
    • 2
  • Haruhiko Sugimura
    • 3
  • Takashi Uchiyama
    • 4
  • Hiroyuki Konno
    • 1
  1. 1.Second Department of SurgeryHamamatsu University School of MedicineHamamatsuJapan
  2. 2.Department of RadiologyHamamatsu University School of MedicineHamamatsuJapan
  3. 3.First Department of PathologyHamamatsu University School of MedicineHamamatsuJapan
  4. 4.Department of SurgeryKikugawa General HospitalKikugawaJapan

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