Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae
An isolated descending colonic stricture is an unlikely complication of acute pancreatitis, with the nonspecific symptoms of colonic stricture making the overall diagnosis difficult. Crohn’s disease (CD) and tuberculosis (TB) are the two common etiologies of an isolated colonic stricture and may pre...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-03-01
|
| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/2324709619834594 |
| _version_ | 1818369722592264192 |
|---|---|
| author | Amrendra Kumar Mandal MD Paritosh Kafle MD Pradip Puri MD Baikuntha Chaulagai MD Muhammad Hassan MD Bikash Bhattarai MD Rajan Kanth MD Vijay Gayam MD |
| author_facet | Amrendra Kumar Mandal MD Paritosh Kafle MD Pradip Puri MD Baikuntha Chaulagai MD Muhammad Hassan MD Bikash Bhattarai MD Rajan Kanth MD Vijay Gayam MD |
| author_sort | Amrendra Kumar Mandal MD |
| collection | DOAJ |
| description | An isolated descending colonic stricture is an unlikely complication of acute pancreatitis, with the nonspecific symptoms of colonic stricture making the overall diagnosis difficult. Crohn’s disease (CD) and tuberculosis (TB) are the two common etiologies of an isolated colonic stricture and may present similarly to colonic stricture related to acute pancreatitis. Unfortunately, colonoscopy and biopsy often cannot determine the etiology, and surgical resection may be needed to provide both symptomatic relief and confirm the diagnosis. As a result, descending colonic stricture may produce a diagnostic dilemma with CD and TB as all 3 conditions may be radiologically and endoscopically indistinguishable. We describe a young male with weight loss and abdominal pain. TB testing was negative, with radiography and ELISA (enzyme-linked immunosorbent assay) testing supporting a diagnosis of the CD. The patient was initiated on sulfasalazine but worsened over the next month. Further investigations revealed that the patient had descending colonic stricture without CD. Therefore, the stricture’s etiology was most likely related to an episode of acute pancreatitis the patient had 2 months before admission and was found to have left colonic segment adherent to the pancreas eventually requiring segmentectomy. Although the pathophysiology of colonic stricture after pancreatitis is unclear, we speculate that inflammatory injury to the colon is an important component. Finally, we emphasize that colonic stricture is a rare complication of pancreatitis. |
| first_indexed | 2024-12-13T23:28:22Z |
| format | Article |
| id | doaj.art-bc4a172dda7340f0a9d68ed0d49d3ce8 |
| institution | Directory Open Access Journal |
| issn | 2324-7096 |
| language | English |
| last_indexed | 2024-12-13T23:28:22Z |
| publishDate | 2019-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj.art-bc4a172dda7340f0a9d68ed0d49d3ce82022-12-21T23:27:29ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962019-03-01710.1177/2324709619834594Acute Pancreatitis Causing Descending Colonic Stricture: A Rare SequelaeAmrendra Kumar Mandal MD0Paritosh Kafle MD1Pradip Puri MD2Baikuntha Chaulagai MD3Muhammad Hassan MD4Bikash Bhattarai MD5Rajan Kanth MD6Vijay Gayam MD7Interfaith Medical Center, Brooklyn, NY, USAInterfaith Medical Center, Brooklyn, NY, USAInterfaith Medical Center, Brooklyn, NY, USAInterfaith Medical Center, Brooklyn, NY, USAInterfaith Medical Center, Brooklyn, NY, USAInterfaith Medical Center, Brooklyn, NY, USACarilion Clinic, Roanoke, VA, USAInterfaith Medical Center, Brooklyn, NY, USAAn isolated descending colonic stricture is an unlikely complication of acute pancreatitis, with the nonspecific symptoms of colonic stricture making the overall diagnosis difficult. Crohn’s disease (CD) and tuberculosis (TB) are the two common etiologies of an isolated colonic stricture and may present similarly to colonic stricture related to acute pancreatitis. Unfortunately, colonoscopy and biopsy often cannot determine the etiology, and surgical resection may be needed to provide both symptomatic relief and confirm the diagnosis. As a result, descending colonic stricture may produce a diagnostic dilemma with CD and TB as all 3 conditions may be radiologically and endoscopically indistinguishable. We describe a young male with weight loss and abdominal pain. TB testing was negative, with radiography and ELISA (enzyme-linked immunosorbent assay) testing supporting a diagnosis of the CD. The patient was initiated on sulfasalazine but worsened over the next month. Further investigations revealed that the patient had descending colonic stricture without CD. Therefore, the stricture’s etiology was most likely related to an episode of acute pancreatitis the patient had 2 months before admission and was found to have left colonic segment adherent to the pancreas eventually requiring segmentectomy. Although the pathophysiology of colonic stricture after pancreatitis is unclear, we speculate that inflammatory injury to the colon is an important component. Finally, we emphasize that colonic stricture is a rare complication of pancreatitis.https://doi.org/10.1177/2324709619834594 |
| spellingShingle | Amrendra Kumar Mandal MD Paritosh Kafle MD Pradip Puri MD Baikuntha Chaulagai MD Muhammad Hassan MD Bikash Bhattarai MD Rajan Kanth MD Vijay Gayam MD Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae Journal of Investigative Medicine High Impact Case Reports |
| title | Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae |
| title_full | Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae |
| title_fullStr | Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae |
| title_full_unstemmed | Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae |
| title_short | Acute Pancreatitis Causing Descending Colonic Stricture: A Rare Sequelae |
| title_sort | acute pancreatitis causing descending colonic stricture a rare sequelae |
| url | https://doi.org/10.1177/2324709619834594 |
| work_keys_str_mv | AT amrendrakumarmandalmd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT paritoshkaflemd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT pradippurimd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT baikunthachaulagaimd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT muhammadhassanmd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT bikashbhattaraimd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT rajankanthmd acutepancreatitiscausingdescendingcolonicstrictureararesequelae AT vijaygayammd acutepancreatitiscausingdescendingcolonicstrictureararesequelae |