Pancreatic pseudocystocolonic fistula treated without surgical or endoscopic intervention

We report here a case of pancreatic pseudocystocolic fistula that was treated without surgical or endoscopic intervention.A 76-year-old woman,presenting with a fever and epigastric pain,was referred to our institution.Three months prior to this admission,the patient had been admitted to the hospital...

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Published inWorld journal of gastroenterology : WJG Vol. 20; no. 7; pp. 1882 - 1886
Main Authors Kwon, Jae Choon, Kim, Bo Yean, Kim, Ah Lim, Kim, Tae Hoon, Park, Myung Il, Jung, Ho Jin, Lim, Jang Hwan, Jung, Jae Kwon, Kim, Hyun Soo, Lee, Dong Wook
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 21.02.2014
Subjects
Acute
Aged
Air
Case Report
Colonoscopy
Drainage
Female
fis
Humans
Pancreatic Fistula - therapy
Pancreatic Pseudocyst - therapy
pancreatitis
Pancreatitis - complications
Pseudocyst
Pseudocystocolic
Tomography, X-Ray Computed
Treatment Outcome
Pseudocystocolic fistula
Pseudocyst
Acute pancreatitis
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Summary:We report here a case of pancreatic pseudocystocolic fistula that was treated without surgical or endoscopic intervention.A 76-year-old woman,presenting with a fever and epigastric pain,was referred to our institution.Three months prior to this admission,the patient had been admitted to the hospital for acute pancreatitis.Abdominal computerized tomography(CT)revealed a 9 cm pseudocyst containing air,and a fistular opening was observed via colonoscopy.After colonoscopy,the abdominal pain was slightly improved,the fever subsided and laboratory results showed decreased C-reactive protein levels.The observed improvement was likely due to the cleansing of the bowel,which induced spontaneous drainage from the pseudocyst into the colon.Antibiotic therapy was administered and daily bowel cleansing was performed using a polyethylene glycol solution.After three weeks,a follow-up CT revealed that the size of the pseudocyst had decreased significantly from 9 to 5.3 cm.In addition,laboratory tests were improved.The patient was able to resume a normal diet and was discharged in good overall health from the hospital,without aggravation of the symptoms.A colonoscopy performed 3 mo later and a follow-up CT performed 6 mo later confirmed that both the fistula and pseudocyst had completely disappeared.
Bibliography:Jae Choon Kwon;Bo Yean Kim;Ah Lim Kim;Tae Hoon Kim;Myung Il Park;Ho Jin Jung;Jang Hwan Lim;Jae Kwon Jung;Hyun Soo Kim;Dong Wook Lee;Division of Gastroenterology and Hepatology,Department of Internal Medicine,Daegu Fatima Hospital,Dong-gu Daegu,701-600,South Korea
ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
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Correspondence to: Dong Wook Lee, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, 183 Ayangro, Dong-gu Daegu 701-600, South Korea. storm5333@naver.com
Telephone: +82-53-9407460   Fax: +82-53-954-7417
Author contributions: Kim BY and Kim AL were the attending doctors for the patient; Kim TH and Park MI were involved in the preparation of the manuscript; Jung HJ and Lim JH helped with diagnosis and management of the patient; Jung JK performed the colonoscopy; Kim HS designed the case report; Kwon JC wrote the manuscript; Lee DW revised the manuscript for critical intellectual content.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v20.i7.1882