Descending colon fistula: Unusual complication of severe acute pancreatitis a case report

INTRODUCTION: The incidence of colonic complications from acute pancreatitis (AP) and severe AP are 3.3% and 15%, respectively. We report a case of descending colon fistula secondary to severe AP and its management. CASE PRESENTATION: We report a case of a 35-year-old male hospitalized in our department for severe acute pancreatitis (grade E of Balthazar classification). Initially, the evolution was favorable under medical management. Two months later, he was readmitted for infection of the necrosis with a descending colon fistula. As we did not have the possibility of performing a CT scan drainage, our plan was to do surgical drainage under general anesthesia. CONCLUSION: The colonic involvement following AP or severe AP is rare and difficult to diagnoses. Conservative treatment when some conditions are available should be the best choice; it is associated with lower risk of morbidity and mortality.