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降结肠瘘:重症急性胰腺炎的罕见并发症——病例报告

Descending colon fistula: Unusual complication of severe acute pancreatitis a case report.

作者信息

Zaafouri Haithem, Dawood Atif, Mesbahi Meriam, Alotaibi Turki, Ahmadi Mourouj A L, Aiat Maged

机构信息

Department of General Surgery, King Abdul Aziz Hospital, Jeddah, Saudi Arabia.

General Surgery Department, Habib Thameur Hospital, Tunis, Tunisia.

出版信息

Ann Med Surg (Lond). 2022 Mar 1;75:103426. doi: 10.1016/j.amsu.2022.103426. eCollection 2022 Mar.

Abstract

INTRODUCTION

The incidence of colonic complications from acute pancreatitis (AP) and severe AP are 3.3% and 15%, respectively. We report a case of descending colon fistula secondary to severe AP and its management.

CASE PRESENTATION

We report a case of a 35-year-old male hospitalized in our department for severe acute pancreatitis (grade E of Balthazar classification).Initially, the evolution was favorable under medical management. Two months later, he was readmitted for infection of the necrosis with a descending colon fistula. As we did not have the possibility of performing a CT scan drainage, our plan was to do surgical drainage under general anesthesia.

CONCLUSION

The colonic involvement following AP or severe AP is rare and difficult to diagnoses. Conservative treatment when some conditions are available should be the best choice; it is associated with lower risk of morbidity and mortality.

摘要

引言

急性胰腺炎(AP)和重症急性胰腺炎的结肠并发症发生率分别为3.3%和15%。我们报告一例重症急性胰腺炎继发降结肠瘘及其治疗情况。

病例介绍

我们报告一例35岁男性因重症急性胰腺炎(巴尔萨泽分级E级)入住我科。最初,在药物治疗下病情进展顺利。两个月后,他因坏死感染并伴有降结肠瘘再次入院。由于我们无法进行CT引导下引流,我们的计划是在全身麻醉下进行手术引流。

结论

急性胰腺炎或重症急性胰腺炎后的结肠受累情况罕见且难以诊断。在某些条件具备时,保守治疗应是最佳选择;它与较低的发病率和死亡率风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29dc/8977942/6d9309d1d909/gr1.jpg

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