Benedetti Valentini G, Sciutti S, Mariani E, Bartocci M, Minciotti E, Furiosi P
Minerva Chir. 1981 Feb 15;36(3):143-50.
Pathological involvement of the colon secondary to acute and chronic pancreatitis is a rare complication of major clinical interest. Contiguity with the tail of the pancreas and certain anatomical relationships, particularly at the level of the peritoneal reflections, explain the involvement of, particularly, the left corner of the colon and the adjacent part of the transverse colon. The clinical forms may be listed as follows: 1) Adynamic ileus of the transverse colon associated, on direct radiological examination, with the picture of proximal colon distension with clear-cut interruption at the level of the transverse colon or left flexure. 2) Stenosis of the left flexure due to pericolitis and to the fibrosclerosing process that may take in other contiguous organs also. 3) Fistula of the left flexure or of the adjacent part of the transverse colon due to parietal necrosis and vascular impairment. Also described is an association of fistula and massive haemorrhage for erosion of the colon and of the splenic artery by pancreatic pseudocyst. Two clinical cases are presented along with the basic elements of pathology, diagnosis and therapy.
急性和慢性胰腺炎继发的结肠病理累及是一种具有重大临床意义的罕见并发症。与胰尾的毗邻关系以及某些解剖学关系,特别是在腹膜反折层面,解释了结肠左角及横结肠相邻部分为何会受累。临床类型如下:1)横结肠动力性肠梗阻,直接放射学检查显示近端结肠扩张,在横结肠或左结肠曲处有明确中断。2)由于结肠周炎及可能累及其他相邻器官的纤维硬化过程导致左结肠曲狭窄。3)由于壁层坏死和血管损害导致左结肠曲或横结肠相邻部分形成瘘管。还描述了因胰腺假性囊肿侵蚀结肠和脾动脉而导致的瘘管与大量出血并存的情况。本文介绍了两例临床病例以及病理、诊断和治疗的基本要点。