A CASE REPORT OF POST-TRAUMATIC PANCREATITIS WITH COLONIC STRICTURE AND SPLENIC PSEUDOANEURYSM CAUSED BY CONTINUOUS VIBRATION TO THE ABDOMEN

Abstract

A 47-year-old man, who received continuous vibration to the abdomen by an Air-breaker during construction work, visited our hospital because of left hypochondralgia. Abdominal computed tomography (A-CT) scan showed wall thickening of the colon in the splenic flexure and edematous fatty tissue. Barium enema study revealed narrowing with marginal serration of this portion and colonoscopy showed slightly edematous mucosa, suggesting the colon was involved with extra-colonic cancer or inflammation. However, no signs of malignancy were found at all. His pain was reduced and he stopped coming to the hospital. One year later, he had pain again and was admitted to the hospital. Colonic stricture had gone at this point, however, A-CT scan showed pancreatic cyst and splenic aneurysm near the splenic hilus. From his occupational history, we diagnosed post-traumatic pancreatitis with pancreatic pseudocyst and splenic pseudoaneurysm caused by continuous vibration to the abdomen. Distal pan-createctomy and splenectomy were performed. The mesocolon around the splenic flexure and the splenocolic ligament had a scar contracture probably due to pancreatitis, which suggested the colonic stricture one year previous might have been followed by post-traumatic pancreatitis. In cases of unknown original colonic stenosis, we must consider possible latent pancreatitis.