November 12, 2014
Notes: Issa, Yama
Ahmed Ali, Usama
Bouwense, Stefan A W
van Santvoort, Hjalmar C
van Goor, Harry
Research Support, Non-U.S. Gov’t
Surg Endosc. 2014 Feb;28(2):405-12. doi: 10.1007/s00464-013-3193-z. Epub 2013 Sep 6.
Author Address: Department of Surgery, Academic Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands, email@example.com.
Reference Type: Journal Article
Record Number: 5054Author: Ito, K., Igarashi, Y., Mimura, T., Kishimoto, Y., Kamata, I., Kobayashi, S., Yoshimoto, K. and Okano, N.
Title: Severe Acute Pancreatitis with Complicating Colonic Fistula Successfully Closed Using the Over-the-Scope Clip System
Journal: Case Rep Gastroenterol
Short Title: Severe Acute Pancreatitis with Complicating Colonic Fistula Successfully Closed Using the Over-the-Scope Clip System
Alternate Journal: Case reports in gastroenterology
ISSN: 1662-0631 (Electronic)
Accession Number: 23904844
Abstract: A 44-year-old man presenting to our hospital emergency room with abdominal pain was hospitalized for hyperlipidemic acute pancreatitis. A pig-tail catheter was placed percutaneously to drain an abscess on day 22. Although the abscess improved gradually and good clinical progress was seen, pancreatic duct disruption was strongly suspected and endoscopic retrograde cholangiopancreatography was performed on day 90. An endoscopic nasopancreatic drainage tube was placed, but even with concurrent use of a somatostatin analogue, treatment was ineffective. Surgical treatment was elected, but was subsequently postponed as the abscess culture was positive for extended-spectrum beta-lactamase-producing Escherichia coli and methicillin-resistant Staphylococcus aureus. Drainage tubography showed a small fistula of the colon at the splenic flexure on day 140. Colonoscopy was performed on day 148. After indigo carmine had been injected, a fistula into the splenic flexure of the colon showed blue staining. The over-the-scope clip (OTSC) system was used to seal the fistula and complete closure was shown. A liquid diet was started on day 159 and was smoothly upgraded to a full diet. Following removal of the pancreatic stent on day 180, drainage volume immediately decreased and the percutaneous drain was removed. On day 189, computed tomography showed no exacerbation of the abscess and the patient was discharged on day 194. This case of colonic fistula caused by severe acute pancreatitis was successfully treated using the OTSC system, avoiding the need for an open procedure.