[Lesions of the colon secondary to pancreatitis]

Abstract

Pathological involvement of the colon secondary to acute and chronic pancreatitis is a rare complication of major clinical interest. Contiguity with the tail of the pancreas and certain anatomical relationships, particularly at the level of the peritoneal reflections, explain the involvement of, particularly, the left corner of the colon and the adjacent part of the transverse colon. The clinical forms may be listed as follows: 1) Adynamic ileus of the transverse colon associated, on direct radiological examination, with the picture of proximal colon distension with clear-cut interruption at the level of the transverse colon or left flexure. 2) Stenosis of the left flexure due to pericolitis and to the fibrosclerosing process that may take in other contiguous organs also. 3) Fistula of the left flexure or of the adjacent part of the transverse colon due to parietal necrosis and vascular impairment. Also described is an association of fistula and massive haemorrhage for erosion of the colon and of the splenic artery by pancreatic pseudocyst. Two clinical cases are presented along with the basic elements of pathology, diagnosis and therapy.