title: [Jejunocolic fistulae after pylorus-preserving pancreatic head resection: an uncommon cause of chronic diarrhea].
abstract: 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.
authors.affiliation: 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
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlas
authors.forename: Matthias
authors.initials: M
authors.lastname: Markuske
authors.forename: Katrin
authors.initials: K
authors.lastname: Schierle
authors.forename: Joachim
authors.initials: J
authors.lastname: Mössner
authors.forename: Michael
authors.initials: M
authors.lastname: Bartels
authors.forename: Hans
authors.initials: H
authors.lastname: Bödeker
mesh_terms: 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
references.citation: Z Gastroenterol. 2004 Oct;42(10):1117-28
references.pmid: 15508057
references.citation: Gastroenterology. 2008 May;134(5):1406-11
references.pmid: 18471517
references.citation: Ann Surg. 1980 Sep;192(3):306-10
references.pmid: 7416828
references.citation: Gastroenterology. 1999 Jun;116(6):1464-86
references.pmid: 10348832
references.citation: Can J Surg. 2000 Feb;43(1):53-6
references.pmid: 10714259
references.citation: Singapore Med J. 2009 Aug;50(8):e274-6
references.pmid: 19710957
references.citation: Int J Surg. 2009 Aug;7(4):305-12
references.pmid: 19501199
references.citation: Turk J Gastroenterol. 2008 Sep;19(3):152-7
references.pmid: 19115149
references.citation: Dtsch Med Wochenschr. 2008 Feb;133(9):415-26
references.pmid: 18288629
references.citation: Rom J Gastroenterol. 2004 Mar;13(1):39-41
references.pmid: 15054525
references.citation: Curr Opin Gastroenterol. 2007 Sep;23(5):522-34
references.pmid: 17762558
references.citation: Am J Surg. 1997 Apr;173(4):257-63
references.pmid: 9136776
references.citation: Gastroenterology. 2006 Apr;130(5):1480-91
references.pmid: 16678561
references.citation: Dtsch Arztebl Int. 2009 Nov;106(48):789-94
references.pmid: 20038981
references.citation: Jpn J Surg. 1990 Nov;20(6):704-6
references.pmid: 2084296
references.citation: Clin Trials. 2008;5(5):534-45
references.pmid: 18827046
references.citation: J Gastrointest Surg. 2009 Jan;13(1):163-73
references.pmid: 18496727