Descending colon fistula: Unusual complication of severe acute pancreatitis a case report

• Published in: Annals of medicine and surgery 2022-03, Vol.75, p.103426, Article 103426
• Main Authors: Zaafouri, Haithem, Dawood, Atif, Mesbahi, Meriam, Alotaibi, Turki, Ahmadi, Mourouj A.L., Aiat, Maged
• Format: Article
• Language: English
• Subjects: Acute pancreatitis; Case Report; Colonic fistula; Conservative management; Drainage
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103426

The incidence of colonic complications from acute pancreatitis (AP) and severe AP are 3.3% and 15%, respectively. We report a case of descending colon fistula secondary to severe AP and its management. We report a case of a 35-year-old male hospitalized in our department for severe acute pancreatitis (grade E of Balthazar classification). Initially, the evolution was favorable under medical management. Two months later, he was readmitted for infection of the necrosis with a descending colon fistula. As we did not have the possibility of performing a CT scan drainage, our plan was to do surgical drainage under general anesthesia. The colonic involvement following AP or severe AP is rare and difficult to diagnoses. Conservative treatment when some conditions are available should be the best choice; it is associated with lower risk of morbidity and mortality. •Knowledge about colonic complications from AP has been limited to few case reports.•Thus diagnostic and management dilemmas continue to persist. The clinical presentation can be variable.•Nonspecific and could occur quite late in the disease process. For the management.•There are no evidence-based guidelines.