급성췌장염의 합병증으로 발생한 대장폐쇄 1예

• Published in: The Korean journal of gastroenterology Vol. 51; no. 4; pp. 255 - 258
• Main Authors: 유성수, Sung Soo Yoo, 최선근, Sun Keun Choi, 이돈행, Don Haeng Lee, 정석, Seok Jeong, 박성학, Sung Hak Park, 정영국, Young Kook Chung, 김형길, Hyung Gil Kim, 신용운, Yong Woon Shin
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30.04.2008
• Subjects: Intestinal obstruction; Pancreatitis; 내과학
• ISSN: 1598-9992; 2233-6869

In acute pancreatitis, colonic complications such as mechanical obstruction, ischemic necrosis, hemorrhage, and fistula are rare but their outcomes are fatal. It is known that colonic obstruction in acute pancreatits is more likely found in splenic flexure and transverse colon caused by severe inflammation of body and tail of pancreas leading to pressure necrosis. A 43-year-old man presented with abdominal distension lasting for 2 weeks. The patient had been admitted to our institution 6 weeks prior to the current admission, and the abdominal CT scan performed during the first admission revealed the pancreatic enlargement with peri-pancreatic fatty infiltration and fluid collection. At that time he was diagnosed as acute pancreatitis. The conservative management resulted in clinical improvent so that the patient was discharged. Upon the second admission, abdominal CT scan revealed multiple pseudocysts in the tail portion of pancreas with concominant wall thickening and narrowing of the proximal descending colon, and a dilatation of the bowel proximal to the splenic flexure. An obstruction of the descending colon as a complication of acute pancreatitis was suspected and the patient underwent left hemicolectomy. Abdominal distension was relieved after the operation and he was discharged on the 15th hospital days. (Korean J Gastroenterol 2008;51:255-258)