A Case of Colonic Perforation Complicated with Acute Pancreatitis

Toshio Nakamura, Keiji Maruyama, Hidefumi Kashiwabara, Kenichi Sunayama, Ko Ohata, Atsuko Fukazawa, Yoichi Watahiki^*, Raisuke Nishiyama^*, Toshikazu Kanai^* and Satoshi Nakamura

Department of Surgery II, Hamamatsu University of Medicine, ^*Department of Surgery, Inasa Red Cross Hospital

In a case of colonic perforation caused by acute pancreatitis, a 48-year-old man was hospitalized with high fever and general fatigue. Abdominal computed tomography revealed a large mass containing much gas in the retroperitoneal space. A gastrographin enema study showed that contrast medium leaked from the intestine. Emergency surgery was conducted based on a diagnosis of colonic perforation. Subtotal colectomy with proximal colostomy was done and the retroperitoneal space opened for drainage. Histological diagnosis of the resected specimen showed perforation due to acute pancreatitis. Colonic perforation caused by acute pancreatitis is a rare but potentially lethal complication. Accurate and expeditious documentation of these colonic complications is therefore important in planning appropriate surgical therapy.

Key words
pancreatitis, colonic perforation, retroperitoneal abscess

Reprint requests
Toshio Nakamura Department of Surgery II, Hamamatsu University School of Medicine 3600 Handa-cho, Hamamatsu, 431-3192 JAPAN

Accepted
February 28, 2001

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