Obstruction near hepatic flexure in pancreatitis. A rarely reported sign.

Abstract

RADIOLOGICAL and clinical evidence of largebowel obstruction in pancreatitis has been infrequently reported in the literature. Narrowing at the splenic flexure, accompanied by distension of both the large and small bowel, was described in 1957. 1 Glenn and Baylin 2 noted spasm in the midtransverse among other x-ray features of acute pancreatitis. Australian authors 3,4 have used the term colon cut-off sign to describe the finding of gas in the ascending up to the hepatic flexure, with absence of gas in the transverse colon. The following case is one in which survey films of the abdomen, repeated barium examinations of the colon, and serum amylase determinations illustrate a temporary obstruction near the hepatic flexure, due to an acute attack of pancreatitis. The lesion at one point was thought to so resemble carcinoma that operation was planned, but fortunately never executed. Report of a Case A 26-year-old white