[Intestinal occlusion due to pancreatitis mimicking stenosing neoplasm of the splenic angle of the colon].
Colonic involvement in patients with severe acute pancreatitis or chronic pancreatitis is common and complications such as paralytic ileus, segmental necrosis and pancreatic-colonic fistulae have been described. However, mechanical occlusion of the colon due to pancreatitis is infrequent. We present the case of a 45-year-old man with occlusion of the colon secondary to asymptomatic pancreatitis mimicking a locally advanced stenosing neoplasm of the splenic angle. Ten years prior to the present episode the patient had presented acute alcoholic pancreatitis complicated by a pseudocyst requiring surgery. The current reason for admission was abdominal colic pain and constipation with onset 5 days previously. Contrast enema was administered showing colonic occlusion caused by stenosis at the splenic flexure, suggesting the presence of a neoplasm. Urgent laparotomy showed the presence of a tumor originating in the colon that infiltrated the splenic hilum. Subtotal colectomy and en-bloc splenectomy were performed. Histopathological analysis showed pericolonic inflammation and fibrosis secondary to pancreatitis; the colonic mucosa showed no tumoral infiltration. To date, fewer than 30 cases of this infrequent complication have been published.
Pascual
M
M
Unidad de Cirugía Colorrectal, Servicio de Cirugía, Hospital del Mar, Barcelona, Spain.
Pera
M
M
Martínez
I
I
Miquel
R
R
Grande
L
L
D000208:Acute Disease; D000437:Alcoholism / Q000150:complications; D003082:Colectomy; D003092:Colitis / Q000209:etiology; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005355:Fibrosis; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000601:surgery; D010195:Pancreatitis / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D013156:Splenectomy