caa a22 4500 606245324 CHVBK 20210128101334.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s12262-012-0717-z doi (NATIONALLICENCE)springer-10.1007/s12262-012-0717-z Severe Colonic Complications requiring Sub-Total Colectomy in Acute Necrotizing Pancreatitis—A Retrospective Study of 8 Patients [Elektronische Daten] [Anish Nagpal, Harshad Soni, Sanjiv Haribhakti] Colonic involvement in acute pancreatitis is associated with high mortality. Diagnosis of colonic pathology complicating acute pancreatitis is difficult. The treatment of choice is resection of the affected segment. The aim of this study is to evaluate the feasibility of aggressive surgical approach when colonic complication is suspected. Retrospectively, 8 patients with acute necrotizing pancreatitis and colonic complications (2006-2010) were reviewed. Eight patients with acute necrotizing pancreatitis requiring colonic resection were evaluated. Presentation was varied, including rectal bleeding (2), clinical deterioration during severe pancreatitis (4), colonic contrast leak on CT scan (1) and large bowel obstruction (1). Typically, patients with severe acute pancreatitis had colonic pathology obscured and unrecognized initially because of the ongoing, fulminant inflammatory process. All eight patients underwent Sub-total colectomy & ileostomy for suspected imminent or overt ischemia/perforation, based on the outer aspect of the colon. There was one mortality due to severe sepsis and multiorgan dysfunction syndrome. All other patients recovered well and later underwent closure of the stoma. Recognition of large bowel involvement may be difficult because of nonspecific symptoms or be masked by the systemic features of a critical illness. Clinicians should be aware that acute pancreatitis may erode or inflame the large bowel, resulting in lifethreatening colonic necrosis, bleeding or perforation. In our series of eight patients, we observed that mortality can be reduced by this aggressive surgical approach. We recommend a low threshold for colonic resection due to unreliable detection of ischemia or imminent perforation by outside inspection during surgery for acute necrotizing pancreatitis. Association of Surgeons of India, 2012 Colectomy nationallicence Necrotizing pancreatitis nationallicence Complications nationallicence Nagpal Anish Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut Soni Harshad Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut Haribhakti Sanjiv Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut Indian Journal of Surgery Springer India 77/1(2015-02-01), 3-6 0972-2068 77:1<3 2015 77 12262 https://doi.org/10.1007/s12262-012-0717-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-012-0717-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nagpal Anish Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut NATIONALLICENCE 700 1- Soni Harshad Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut NATIONALLICENCE 700 1- Haribhakti Sanjiv Department of Surgical Gastroenterology, Haribhakti Surgical Hospital, 508, Sangita Complex, Opp Doctor House, Nr. Parimal Crossing, 380006,, Ahmedabad, Gujarat, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77/1(2015-02-01), 3-6 0972-2068 77:1<3 2015 77 12262