Acute pancreatitis and necrotizing colitis following extensive burn injury

Abstract

Case: We describe a patient with severe pancreatitis and ischemic colitis after extensive burn injury. An 81-year-old man presented with a 55% total body surface area burn with inhalation injury. A low-density area was detected in the pancreas on the abdominal computed tomography scan on admission. The clinical course of the patient was good until 28 days after injury when he complained of abdominal pain and distension. Abdominal computed tomography revealed acute pancreatitis and ischemic colitis.

Outcome: The patient died 59 days after burn injury.

Conclusions: Extensive burn injury can cause acute pancreatitis. Further work-up is necessary to identify pancreatic complications after severe burn injury.

Keywords: Complications; mesenteric ischemia; pancreatic pseudocyst.

Figure 1

Abdominal computed tomography image of an 81‐year‐old man on the first day after extensive burn injury. The white circle indicates an area of low density in the pancreas.

Figure 2

Changes in serum amylase levels, white blood cell counts, and C‐reactive protein levels throughout the clinical course of an 81‐year‐old man treated for extensive burn injury. After 40 days, levels of serum amylase and C‐reactive protein were increased. These increases may have represented the development of acute pancreatitis and ischemic colitis.

Figure 3

Peritoneal fluid, portal air, and partial ischemic change in the ascending colon on abdominal computed tomography in an 81‐year‐old man 43 days after extensive burn injury. White arrows indicate air in the portal vein (A), superior mesenteric vein (C), and right colic vein (D). The white circle (B) indicates a ruptured pancreatic pseudocyst. These findings are suggestive of acute pancreatitis and ischemic colitis.