Colonic involvement in acute necrotizing pancreatitis: results of surgical treatment

In this series of 15 personal cases, the authors emphasize the unusual colonic complications which occur during acute necrotizing pancreatitis. These lesions always indicate a particularly severe pancreatitis and depend on 2 factors: extension of pancreatic necrosis into the mesocolon with encasing pericolic tumoral fibrosis, and parietal ischemic necrosis secondary to shock and thrombosis with infection. Laparotomy followed by colectomy is indicated in these severely ill patients. Prognosis is poor (8 deaths of 15 patients), sometimes in spite of extensive pancreatic excision. The existence of colonic complications gives evidence of the particular severity of certain forms of pancreatitis.