[Two cases of colonic obstruction after acute pancreatitis].
Several forms of colonic complications are rarely observed during the clinical course of acute pancreatitis, and potentially fatal in some cases. Colonic lesions associated with acute pancreatitis can be divided into several groups from a pathogenic point of view. Possible pathogenesis includes: 1) spread of pancreatic enzymes through the retroperitoneum to mesocolon, causing pericolitis, 2) external inflammatory compression by mesocolic mass secondary to necrosis of fatty tissue, and 3) hypotension due to shock, and thrombosis of mesenteric arteries. These might lead to colonic infarction, fistula formation, perforation, and obstruction during follow-up. We report two cases of colonic obstruction following acute pancreatitis with possible different mechanisms and review Korean cases. One patient developed colonic obstruction due to severe necrotizing pancreatitis, possibly as a result of pericolitis, and the other developed stenosis as a result of ischemic colitis induced by acute pancreatitis.
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Dae Keun
DK
Pyun
Kyung Jo
KJ
Kim
Byong Duk
BD
Ye
Jeong Sik
JS
Byeon
Seung Jae
SJ
Myung
Suk Kyun
SK
Yang
Jin Ho
JH
Kim
Sang Nam
SN
Yoon
D000208:Acute Disease; D003108:Colonic Diseases / Q000175:diagnosis* / Q000209:etiology; D003251:Constriction, Pathologic / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed