慢性すい炎急性増悪による結腸狭窄の１例

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  • A Case of Colonic Stenosis Accompanying an Acute Exacerbation of Chronic Pancreatitis.

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We report a case of colonic stenosis complicated by an acute exacerbation of chronic pancreatitis. A 52-year-old man, who had a history of hospitalization for acute pancreatitis, visited our hospital complaining of upper abdominal pain. As blood leukocytes and the serum amylase were elevated, he was admitted with a diagnosis of an acute exacerbation of chronic pancreatitis.<BR>After admission, biochemical examination revealed disseminated intravascular coaguration (DIC), and the patient gradually progressed to a state of shock. Although the shock state was improved, a symptom of bowel obstruction appeared, and a long tube was inserted. Barium enema and gasrographin through long-tube examination revealed a stenosis at the transverse, ascending colon and cecum, but barium passed through the stenosis. A colonoscope did not pass through the stenosis at the transverse colon. As conservative treatment for three months was not successful, a right hemicolectomy was performed. Histologically, severe inflammatory change and fibrosis were shown in the submucosal and proper muscle layer. An intestinal stenosis complicated by pancreatitis may be treated by surgery after conservative therapy for three months has failed.

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