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  • Title: [Massive rectal hemorrhage by colonic fistulization of a pancreatitis lesion].
    Author: Quandalle P, Rousseau B, L'Hermine C, Ribet M.
    Journal: J Chir (Paris); 1985 Dec; 122(12):665-9. PubMed ID: 3878844.
    Abstract:
    Rectal hemorrhage of massive proportions in 4 patients was due to vascular erosion of a necrotic pancreatitis focus, and fistulization at the splenic angle of colon. This serious complication may arise during the course of acute pancreatitis or an acute episode of chronic pancreatitis. A literature review showed 22 similar cases reported. Diagnosis is suggested by the discovery of a stenosis of colon in a case of pancreatitis, and can be confirmed by emergency arteriography or operative findings. Hemorrhage is usually from the splenic artery but erosion of a left renal artery has been described. Treatment is by embolization during angiography followed by drainage of the pancreatic necrosis and a colon bypass operation, or by splenopancreatectomy combined with colectomy. Use of these two procedures led to recovery in the 4 cases reported.
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