Negro P, D'Amore L, Saputelli A, Talarico C, Scaccia M, Tuscano D, Gossetti F, Carboni M
University of Rome La Sapienza II Surgical Clinic.
Ann Ital Chir. 1995 Mar-Apr;66(2):223-31.
Lesions of the colon are generally considered to be uncommon sequelae of pancreatitis. They include: localized paralytic ileus (colon cut-off sign), necrosis, fistulae, stenosis and varices. On the basis of an extensive review of the literature (432 cases), it is suggested indeed that the real incidence is significant. The anatomic relationship of the large bowel to the pancreas is an important factor in the genesis and localization of the lesions. Enzymatic-inflammatory and ischemic processes are involved in the most highly supported theories. Colon cut-off sign is almost always spontaneously reversible and may represent an "alarm" for more serious complications. Massive necrosis develops during the early stage of severe pancreatitis and its mortality rate has been reported to be high. Fistulae are late complications of the disease, associated with a protracted course and probably a consequence of pancreatic suppuration or pseudocysts. Stenoses are the most interesting colonic complications following pancreatitis and caused by either acute obstruction of the colon due to an inflammatory mass or progressive obstruction due to pericolic fibrosis. In this case, the clinical picture may mimic carcinoma.
结肠病变通常被认为是胰腺炎罕见的后遗症。它们包括：局限性麻痹性肠梗阻（结肠截断征）、坏死、瘘管、狭窄和静脉曲张。基于对大量文献（432例）的广泛回顾，确实提示实际发病率较高。大肠与胰腺的解剖关系是病变发生和定位的重要因素。酶性炎症和缺血过程参与了最受支持的理论。结肠截断征几乎总是可自发逆转，可能是更严重并发症的一个“警示”。大面积坏死发生在重症胰腺炎的早期，据报道其死亡率很高。瘘管是该病的晚期并发症，病程迁延，可能是胰腺化脓或假性囊肿的结果。狭窄是胰腺炎后最有趣的结肠并发症，由炎性肿块导致的结肠急性梗阻或结肠周围纤维化引起的进行性梗阻所致。在这种情况下，临床表现可能类似癌症。
