SciELO - Scientific Electronic Library Online

 
vol.52 issue1Endometriotic stricture of the sigmoid colon presenting with intestinal obstruction author indexsubject indexarticles search
Home Pagealphabetic serial listing  

South African Journal of Surgery

On-line version ISSN 2078-5151
Print version ISSN 0038-2361

Abstract

NAIDOO, V G  and  ONYANGO, S A. Colonic perforation following endoscopic retrograde cholangiopancreatography-associated pancreatitis. S. Afr. j. surg. [online]. 2014, vol.52, n.1, pp.29-31. ISSN 2078-5151.

We highlight a potentially lethal complication of acute severe pancreatitis that may not be suspected in severely ill patients. A 41-year-old woman developed acute severe pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis. When her condition deteriorated dramatically after 2 weeks of intensive medical management, a computed tomography scan and water-soluble contrast enema examination revealed a large colonic perforation and associated collection in the right flank. Surgical management included an extended right hemicolectomy and a second laparotomy to attend to soiling at the surgical site. She survived and was discharged. Colonic perforation is a recognised complication of pancreatitis that carries a high mortality. It may result from a combination of ischaemia to the colon and a direct effect of noxious pancreatic enzymes. Almost all cases are only diagnosed at laparotomy. In view of the current trend of non-surgical management of pancreatitis and associated complications, colonic perforation should be considered in patients who deteriorate or fail to improve. To our knowledge this is the first case of a secure pre-operative diagnosis of colonic perforation due to to pancreatitis.

        · text in English     · English ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License