doiSerbia

Necrosis of the duodenum resulting from acute necrotising pancreatitis and treated with complete duodenopancreatectomy

Čolović Radoje (Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Grubor Nikica (Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Radak Vladimir (Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Čolović Nataša (Institut za hematologiju, Klinički centar Srbije, Beograd)
Jovanović Miodrag (Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)
Stojković Mirjana (Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd)

Necrosis of the duodenum resulting from acute necrotising pancreatitis is a rare but potentially lethal complication. A small number of cases has been reported so far, the majority of which having, unfortunately, had a lethal outcome. We present the cases of two patients, a 21-year-old woman and a 54- year-old man, both suffering from extensive duodenal necrosis stemming from acute necrotising pancreatitis, and both cases involving the second and third sections of the duodenum, one of which was probably caused by the thrombosis of nutritive blood vessels, the other by an abscess of the head of the pancreas. Due to the extent of the necrosis of the duodenum, there was no option to close so large a hole or to employ any less drastic procedure, so that a complete duodenopancreatectomy had to be performed. One patient survived and has remained in good health for a period of almost ten years, to date. The other patient died six days after surgery due to infection, in spite of an absence of any sort of anastomic complications.

Keywords: acute pancreatitis, duodenal necrosis, duodenopancreatectomy