[Intestinal occlusion due to pancreatitis mimicking stenosing neoplasm of the splenic angle of the colon].

Abstract

Colonic involvement in patients with severe acute pancreatitis or chronic pancreatitis is common and complications such as paralytic ileus, segmental necrosis and pancreatic-colonic fistulae have been described. However, mechanical occlusion of the colon due to pancreatitis is infrequent. We present the case of a 45-year-old man with occlusion of the colon secondary to asymptomatic pancreatitis mimicking a locally advanced stenosing neoplasm of the splenic angle. Ten years prior to the present episode the patient had presented acute alcoholic pancreatitis complicated by a pseudocyst requiring surgery. The current reason for admission was abdominal colic pain and constipation with onset 5 days previously. Contrast enema was administered showing colonic occlusion caused by stenosis at the splenic flexure, suggesting the presence of a neoplasm. Urgent laparotomy showed the presence of a tumor originating in the colon that infiltrated the splenic hilum. Subtotal colectomy and en-bloc splenectomy were performed. Histopathological analysis showed pericolonic inflammation and fibrosis secondary to pancreatitis; the colonic mucosa showed no tumoral infiltration. To date, fewer than 30 cases of this infrequent complication have been published.

• Authors: M Pascual, M Pera, I Martínez, R Miquel, L Grande
• Journal: Gastroenterologia y hepatologia (Gastroenterol Hepatol) 2005 Jun-Jul Vol. 28 Issue 6 Pg. 326-8 ISSN: 0210-5705 [Print] Spain
• Vernacular Title: Oclusión intestinal secundaria a pancreatitis que mimetiza una neoplasia estenosante del ángulo esplénico del colon.
• PMID: 15989813 (Publication Type: Case Reports, English Abstract, Journal Article, Review)

Topics

• Acute Disease
• Alcoholism (complications)
• Colectomy
• Colitis (etiology)
• Colonic Diseases (diagnosis, etiology, pathology, surgery)
• Colonic Neoplasms (diagnosis)
• Diagnosis, Differential
• Fibrosis
• Humans
• Intestinal Obstruction (etiology, pathology, surgery)
• Male
• Middle Aged
• Pancreatic Pseudocyst (surgery)
• Pancreatitis (chemically induced, complications, diagnosis, pathology, surgery)
• Postoperative Complications
• Splenectomy