20.500.12556/DKUM-56284 Ishemična lezija debelega črevesa kot posledica akutnega pankreatitisa Ischemic lesion of the colon as a complication of severe acute pancreatitis Akutni nekrozantni pankreatitis v redkih primerih prizadene debelo črevo. V nastanek so vključeni številni patogenetski mehanizmi. Diagnoza prizadetosti debelega črevsa je zahtevna in se v večini primerov postavi šele med operativnim posegom. Zdravljenje izbire je resekcija prizadetega črevesa z izpeljavo (začasne) kolo- ali ileostome in distalne mukozne fistule. Predstavljamo dva bolnika srednjih let, ki sta bila zaradi akutnega nekrozantnega pankreatitisa sprva zdravljena konzervativno, nato pa je prišlo zaradi nekroze pankreatičnega tkiva do vnetne infiltracije mezekolona prečnegadela debelega črevesa s posledično nekrozo. Zdravljenja sta bila operativno. Prizadetost debelega črevesa kot zaplet akutnega nekrozantnega pankreatitisa je povezana z visoko smrtnostjo. V dveh primerih smo prikazali, da je do nekroze prečnega dela debelega črevesa s perforacijo prišlo šele po določenem času, vzrok in obseg prizadetosti pa je bil odkrit šele med operacijo. Glede na starost bolnikov, odlično splošno kondicijo in težnje po kakovostnem življenju smo se eno leto po resekciji prizadetega črevesa odločili za poseg, s katerim smo spet vzpostavili kontinuiteto črevesja. Colonic involvement is an uncommon complication of severe acute pancreatitis. Several pathogenic mechanisms have been proposed. Diagnosis of colonic pathology is difficult. The definitive diagnosis depends on the surgeon and has to be made intraoperatively. The treatment of choice is resection of the affected segment with forming of a (temporary) colo or ileostomy and a distal mucous fistula. The papaer presents a case study of two middle-aged patients, who were initially treated conservatively due to the acute pancreatitis. The spread of the necrotic pancreatic tissue caused the infiltration and necrosis of the transverse mesocolon. They were treated operatively. Colonic pathology complicating acute pancreatitis is known to be associated with high mortality. In two case studies we are presenting that the necrosis and perforation of the transverse mesocolon appeared after some time, however, the cause and the extent of the involvement were discovered not earlier than before the operation. A year after the resection of the affected segment we decided for the continual operation considering the age of the patient, good health condition and better quality of life. true false false Slovenski jezik Angleški jezik Delo ni kategorizirano 2015-12-21 17:03:05 2015-12-21 17:03:05 2022-06-11 03:09:06 2019-07-11 09:37:57 2006 0 0 str. 87-91 št. 2 Letn. 75 2006 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.3 32893696 2225727 1318-0347 URN:SI:UM:DK:KZIHN8KL http://www.dlib.si/details/URN:NBN:SI:doc-ZUOSPBNI 1 https://dk.um.si/Dokument.php?lang=slv&id=84417 Univerza v Mariboru 0 0 0