title: Pancreatic pseudocystocolonic fistula treated without surgical or endoscopic intervention.
abstract: We report here a case of pancreatic pseudocystocolic fistula that was treated without surgical or endoscopic intervention. A 76-year-old woman, presenting with a fever and epigastric pain, was referred to our institution. Three months prior to this admission, the patient had been admitted to the hospital for acute pancreatitis. Abdominal computerized tomography (CT) revealed a 9 cm pseudocyst containing air, and a fistular opening was observed via colonoscopy. After colonoscopy, the abdominal pain was slightly improved, the fever subsided and laboratory results showed decreased C-reactive protein levels. The observed improvement was likely due to the cleansing of the bowel, which induced spontaneous drainage from the pseudocyst into the colon. Antibiotic therapy was administered and daily bowel cleansing was performed using a polyethylene glycol solution. After three weeks, a follow-up CT revealed that the size of the pseudocyst had decreased significantly from 9 to 5.3 cm. In addition, laboratory tests were improved. The patient was able to resume a normal diet and was discharged in good overall health from the hospital, without aggravation of the symptoms. A colonoscopy performed 3 mo later and a follow-up CT performed 6 mo later confirmed that both the fistula and pseudocyst had completely disappeared.
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Jae Choon
authors.initials: JC
authors.lastname: Kwon
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Bo Yean
authors.initials: BY
authors.lastname: Kim
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Ah Lim
authors.initials: AL
authors.lastname: Kim
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Myung Il
authors.initials: MI
authors.lastname: Park
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Ho Jin
authors.initials: HJ
authors.lastname: Jung
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Jang Hwan
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Jae Kwon
authors.initials: JK
authors.lastname: Jung
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Jae Choon Kwon, Bo Yean Kim, Ah Lim Kim, Tae Hoon Kim, Myung Il Park, Ho Jin Jung, Jang Hwan Lim, Jae Kwon Jung, Hyun Soo Kim, Dong Wook Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Dong-gu Daegu, 701-600, South Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Lee
mesh_terms: D000368:Aged; D000388:Air; D003113:Colonoscopy; D004322:Drainage; D005260:Female; D006801:Humans; D010185:Pancreatic Fistula / Q000628:therapy*; D010192:Pancreatic Pseudocyst / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Acute pancreatitis; Pseudocyst; Pseudocystocolic fistula