Korean J Med > Volume 77(1); 2009 > Article
The Korean Journal of Medicine 2009;77(1):11-15.
A case of acute pancreatitis complicated by pseudocystocolonic fistula
Dal Sic Lee, Hyun Kim, Ji Young Kang, Kyu Ho Lee, Il Hun Bae, Seon Mee Park, Sei Jin Youn
췌장 가성낭종에 발생한 낭종-대장루 1예
이달식, 김 현, 강지영, 이규호, 배일헌, 박선미, 윤세진
Abstract
Pseudocystocolonic fistula is a rare, but occasionally lethal event in acute pancreatitis. Surgery has been the mainstay treatment, but recent literature has reported improvements in non-surgical therapies. Here, we report a case of acute pancreatitis complicated by pseudocystocolonic fistula that was treated by non-surgical means. A 58-year-old man, who consumed excessive alcohol, was admitted with severe abdominal pain. Abdominal computed tomography (CT) showed multiple pancreatic pseudocysts and fistula in the descending colon associated with acute pancreatitis. The fistula opening was identified by colonoscopy, and a diagnosis of pseudocystocolonic fistula was made. The pseudocyst was lavaged with saline through a percutaneous cystic drainage catheter and the patient became asymptomatic. Follow-up abdominal CT confirmed the disappearance of the colonic fistula and multiple pseudocysts. We also provide a review of the most effective non-surgical therapies for pseudocystocolonic fistula associated with acute pancreatitis.
Key Words: Pancreatic pseudocyst; Cystocolonic fistula


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