Successful Management of Gastrointestinal Haemorrhage Associated with Ischaemic Colonic Ulceration in Acute Pancreatitis with Video Assisted Retroperitoneal Debridement
Abstract
Context Colonic involvement is an uncommon but potentially lethal complication of severe acute pancreatitis and has received little attention in the surgical literature. Such complications can range from localized colonic pathology to widespread ischaemic pancolitis. Treatment options have historically been limited to resection of the affected segment. Case report We describe the successful role of video assisted retroperitoneal pancreatic debridement in the management of two cases presenting with major gastrointestinal haemorrhage due to localised colonic ulceration on the background of acute necrotising pancreatitis. Conclusion Video assisted retroperitoneal debridement should be considered early in the management of local colonic complications associated with severe acute necrotising pancreatitis.
Image: Involvement of mesocolon by pancreatic inflammatory process.
Downloads
References
Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterol 2007; 13:5043-51. [PMID 17876868]
Aldridge MC, Francis ND, Glazer G, Dudley HA. Colonic complications of severe acute pancreatitis. Br J Surg 1989; 76:362-7. [PMID 2655821]
Lukash WM. Complications of acute pancreatitis. Am J Gastroenterol 1968; 49:120-5. [PMID 5640830]
Abcarian H, Eftaiha M, Kraft AR, Nyhus LM. Colonic complications of acute pancreatitis. Arch Surg 1979; 114:995-1001. [PMID 485850]
Bouillot JL, Alexandre JH, Vuong NP. Colonic involvement in acute necrotizing pancreatitis: Results of surgical treatment. World J Surg 1989; 13:84-7. [PMID 2728464]
Ravindra KV, Sikora SS, Kumar A, Kapoor VK, Saxena R, Kaushik SP. Colonic necrosis is an adverse prognostic factor in pancreatic necrosis. Br J Surg 1995; 82:109-10. [PMID 7881925]
Adams DB, Davis BR, Anderson MC. Colonic complications of pancreatitis. Am Surg 1994; 60:44-9. [PMID 8273973]
Kriwanek S, Gschwantler M, Beckerhinn P, Armbruster C, Roka R. Complications after surgery for necrotising pancreatitis: Risk factors and prognosis. Eur J Surg 1999; 165:952-7. [PMID 10574103]
Kukora JS. Extensive colonic necrosis complicating acute pancreatitis. Surgery 1985; 97290-3. [PMID 3975849]
Kriwanek S, Armbruster C, Beckerhinn P, Dittrich K, Redl E. Improved results after aggressive treatment of colonic involvement in necrotizing pancreatitis. Hepatogastroenterology 1996; 43:1627-32. [PMID 8975977]
Schein M, Saadia R, Decker G. Colonic necrosis in acute pancreatitis: A complication of massive retroperitoneal suppuration. Dis Colon Rectum 1985; 28:948-50. [PMID 4064856]
Carter CR, McKay CJ, Imrie CW. Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience. Ann Surg 2000; 232:175-80. [PMID 10903593]
Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Localio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol 1974; 61:443-451. [PMID 4835417]
Copyright (c) 2011 Yogesh Puri, Sakhawat H Rahman
This work is licensed under a Creative Commons Attribution 4.0 International License.
As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.