Thomas Karlas, Matthias Markuske, Katrin Schierle, Joachim Mössner, Michael Bartels, Hans Bödeker
{"title":"[Jejunocolic fistulae after pylorus-preserving pancreatic head resection: an uncommon cause of chronic diarrhea].","authors":"Thomas Karlas, Matthias Markuske, Katrin Schierle, Joachim Mössner, Michael Bartels, Hans Bödeker","doi":"10.1007/s00063-010-1033-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In patients with a history of pancreatic surgery, chronic diarrhea is mainly caused by exocrine pancreatic insufficiency. The authors report, for the first time, a case of jejunocolic fistulae as a cause of diarrhea and weight loss after pancreatic head resection.</p><p><strong>Case report: </strong>A 55-year-old patient presented with chronic diarrhea and cachexia. He had undergone pylorus-preserving pancreatic head resection for chronic pancreatitis 8 years earlier. A recent colonoscopy showed an uncommon anatomy of the colon. Gastroscopy and computed tomography revealed several jejunocolic fistulae as the cause of chronic diarrhea. The patient underwent surgery and the fistula-carrying parts of jejunum and colon were resected. After surgery, his clinical status improved and he gained weight.</p><p><strong>Conclusion: </strong>Interenteric fistulae after pylorus-preserving pancreatic head resection have not been reported so far. Impaired synchronization of gastric emptying and bile secretion could be a possible cause of autodigestion in the anastomosis region.</p>","PeriodicalId":18420,"journal":{"name":"Medizinische Klinik","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00063-010-1033-7","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medizinische Klinik","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s00063-010-1033-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: In patients with a history of pancreatic surgery, chronic diarrhea is mainly caused by exocrine pancreatic insufficiency. The authors report, for the first time, a case of jejunocolic fistulae as a cause of diarrhea and weight loss after pancreatic head resection.
Case report: A 55-year-old patient presented with chronic diarrhea and cachexia. He had undergone pylorus-preserving pancreatic head resection for chronic pancreatitis 8 years earlier. A recent colonoscopy showed an uncommon anatomy of the colon. Gastroscopy and computed tomography revealed several jejunocolic fistulae as the cause of chronic diarrhea. The patient underwent surgery and the fistula-carrying parts of jejunum and colon were resected. After surgery, his clinical status improved and he gained weight.
Conclusion: Interenteric fistulae after pylorus-preserving pancreatic head resection have not been reported so far. Impaired synchronization of gastric emptying and bile secretion could be a possible cause of autodigestion in the anastomosis region.