Ascending colon necrosis secondary to acute pancreatitis. A case report and literature review
Barlandas-Quintana E, Vera-Manzano LM, Cuendis-Velázquez A, Chávez-Hernández AF, Pherez-Farah M, Carrión-Astudillo CM, Zubillaga-Mares A. Ascending colon necrosis secondary to acute pancreatitis. A case report and literature review. Am J Med Surg. 2021. August 5(1). 5-7
BACKGROUND. Acute pancreatitis is a common cause of abdominal pain, associated with a wide spectrum of complications. Colonic disease secondary to acute pancreatitis is uncommon, reported only in 1% of the patients. However, if present, there is an important rise in mortality.
CASE PRESENTATION. We present a 29-year-old male referred to the emergency department with clinical evolution, biochemical tests and tomographic images that suggested complicated acute appendicitis. Diagnostic laparoscopy was performed and necrotic patches covering all ascending colon were observed. Later, necrotic pancreatitis was manifested.
DISCUSSION. The diagnosis of the colonic involvement in a patient with acute pancreatitis represents a clinical challenge. It can be suspected for bad progression or image studies demonstrating colonic disease, but the definitive diagnosis is made intraoperative.
CONCLUSION. This emphasizes the importance of a high index of suspicious for the enteral complications in a patient with severe acute pancreatitis. Because of its low specificity and often late presentation, the risk of morbidity and mortality associated increases.
KEY WORDS: necrotic pancreatitis, colonic necrosis, colonic complications