Alsumait A R, Jabbari M, Goresky C A
Can Med Assoc J. 1978 Oct 7;119(7):715-9.
In three cases of pancreaticocolonic fistula presenting before the stage of exsanguinating hemorrhage of severe sepsis the problem was diagnosed on the basis of the clinical history, visualization of the terminal part of the fistula by roentgenography after a barium enema had been given and, in two cases, demonstration of the communication with the pancreatic ductal system by endoscopic retrograde pancreatography. The lesions were repaired surgically. Pancreaticocolonic fistula should be suspected in a patient with upper abdominal pain who has a history of abdominal pain and excessive alcohol consumption and in whom diarrhea and fever, hematochezia or a disappearing abdominal mass develops. Characteristically barium will collect in the terminal part of the fistula and thus permit a tentative diagnosis; the diagnosis can then be confirmed by endoscopic retrograde pancreatography. With this approach surgical treatment can be carried out earlier and the often fatal course of the disorder can be averted.
在三例胰腺结肠瘘患者中，在出现严重脓毒症导致大出血之前，根据临床病史、在进行钡剂灌肠后通过X线检查显示瘘管末端以及在两例患者中通过内镜逆行胰胆管造影显示与胰管系统的连通来诊断问题。病变通过手术修复。对于有上腹部疼痛、腹痛和过量饮酒史且出现腹泻、发热、便血或腹部肿块消失的患者，应怀疑有胰腺结肠瘘。典型的情况是钡剂会聚集在瘘管末端，从而做出初步诊断；然后可通过内镜逆行胰胆管造影来确诊。采用这种方法可以更早地进行手术治疗，避免该疾病通常致命的病程。
