title: Colonic fistula associated with severe acute pancreatitis: report of two cases.
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.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Kosuke
authors.initials: K
authors.lastname: Oishi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Shigeyasu
authors.initials: S
authors.lastname: Ota
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sugimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000208:Acute Disease; D000368:Aged; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000209:etiology; D010195:Pancreatitis / Q000150:complications*