Transcolonic Necrosectomy: A Rarely-Used Pancreatic Debridement Strategy

Necrotizing pancreatitis represents a life-threatening sequela of acute pancreatitis in which rapid necrotization of pancreatic and abdominal tissue leads to inflammation and sometimes infection. Treatment includes debridement of necrotic tissue to prevent inflammation from spreading and antibiotics if infected. Areas of necrosis are accessed through percutaneous drainage, surgical debridement, or upper endoscopy. In this study, we present a case of walled-off necrosis debrided through a fistulous connection to the transverse colon. Transcolonic necrosectomy is a seldom used approach, which could provide treatment options for necrotizing pancreatitis in anatomically amenable patients.