[Jejunocolic fistulae after pylorus-preserving pancreatic head resection: an uncommon cause of chronic diarrhea].
BACKGROUND
In patients with a history of pancreatic surgery, chronic diarrhea is mainly caused by exocrine pancreatic insufficiency. The authors report, for the first time, a case of jejunocolic fistulae as a cause of diarrhea and weight loss after pancreatic head resection.


METHODS
A 55-year-old patient presented with chronic diarrhea and cachexia. He had undergone pylorus-preserving pancreatic head resection for chronic pancreatitis 8 years earlier. A recent colonoscopy showed an uncommon anatomy of the colon. Gastroscopy and computed tomography revealed several jejunocolic fistulae as the cause of chronic diarrhea. The patient underwent surgery and the fistula-carrying parts of jejunum and colon were resected. After surgery, his clinical status improved and he gained weight.


CONCLUSIONS
Interenteric fistulae after pylorus-preserving pancreatic head resection have not been reported so far. Impaired synchronization of gastric emptying and bile secretion could be a possible cause of autodigestion in the anastomosis region.
Karlas
Thomas
T
Department für Innere Medizin, Neurologie und Dermatologie, Medizinische Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Universitätsklinikum Leipzig AöR, Leipzig, Germany. thomas.karlas@medizin.uni-leipzig.de
Markuske
Matthias
M
Schierle
Katrin
K
Mössner
Joachim
J
Bartels
Michael
M
Bödeker
Hans
H
D000714:Anastomosis, Surgical; D002908:Chronic Disease; D003108:Colonic Diseases / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D016145:Endoscopy, Digestive System; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000601:surgery; D007579:Jejunal Diseases / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D050500:Pancreatitis, Chronic / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery; D012086:Reoperation
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