Colonic fistulization due to pancreatitis

Abstract

S PONTANEOUS COLONIC FISTULIZATION due to p a n c r e a t i t i s is u n c o m m o n ; on ly four teen recorded cases were found in a rev iew of the l i t e ra ture . T h e purpose of th is r e p o r t is to record the c l in ical and pa tho log ic fea tu res of four a d d i t i o n a l cases encoun te red a t the Los Angeles C o u n t y H o s p i t a l dur ing the l as t t w e n t y years . Two s ignif icant f ea tu res were demons t r a t e d b y these cases. F i s t u l i z a t i on never occur red dur ing the in i t ia l acu te phase of pancrea t i t i s , r a t h e r i t t ook p lace l a t e r dur ing the evo lu t ion of pe r ipanc rea t i c s u p p u r a t i o n or pseudocys t . Also, f i s tu l iza t ion fai led to influence f a v o r a b l y the course of t he p r i m a r y disease. I t n o t on ly fai led to decompress the pe r ipanc rea t i c col lect ion successful ly as m i g h t be expec ted b u t also a p p e a r e d to induce m a j o r hemor rhage and dea th .