First Report: Mechanical Colonic Obstruction Secondary to Necrotizing Pancreatitis in a Dog

Colonic Obstruction in a Dog With Acute Necrotizing Pancreatitis Evaluated With Ultrasonography and Computed Tomography

Sohee Lim; Sang-June Sohn; Jaegon Ah; Eunjin Kim; Sungsoo Kim

Background

Acute pancreatitis (AP) in dogs may result in local and systemic complications, including peripancreatic fluid collections, necrosis, abscessation, and extrahepatic biliary obstruction. In human medicine, colonic complications—such as ischemia, stenosis, perforation, and rarely mechanical obstruction—are recognized but uncommon, particularly in necrotizing pancreatitis. To date, mechanical colonic obstruction secondary to AP has not been reported in veterinary medicine. This case report describes imaging, surgical, and histopathologic findings in a dog with acute necrotizing pancreatitis complicated by mechanical colonic obstruction.

Methods

A 9-year-old neutered male Miniature Pinscher presented with lethargy, anorexia, vomiting, and abdominal distension. Diagnosis of AP was based on clinical signs, markedly elevated canine pancreas-specific lipase and C-reactive protein concentrations, and ultrasonographic findings. Serial abdominal radiography and ultrasonography were performed during hospitalization. Due to progressive gastrointestinal signs and suspicion of obstruction, contrast-enhanced computed tomography (CT) was performed. Exploratory laparotomy with resection of stenotic bowel segments was undertaken, followed by histopathologic evaluation of excised tissues.

Results

Initial ultrasonography demonstrated pancreatic enlargement with hypoechoic parenchyma, peripancreatic hyperechogenicity, ascites, and mild colonic wall thickening. Despite decreasing inflammatory markers, the dog developed progressive fecal impaction, colonic luminal narrowing, ileal and jejunal dilation, and distal colonic collapse.

CT revealed an irregular, lobulated, low-attenuation peripancreatic mass with non-enhancing regions consistent with pancreatic necrosis. The mass extended from the medial left pancreatic lobe and compressed the ascending and proximal transverse colon, resulting in marked luminal narrowing and proximal intestinal dilation. Additional findings included peritonitis and abrupt narrowing of the common bile duct with proximal dilation.

Surgical exploration confirmed extensive adhesions involving the left pancreatic lobe, a peripancreatic abscess, and firm adherence to the transverse colon causing stenosis. Resection of stenotic colonic and ileal segments was performed. Histopathology revealed severe fecal impaction, mucosal ulceration, neutrophilic infiltration, peritoneal fibrosis, and focal necrotizing and fibrosing steatitis. No neoplasia was identified. The patient developed postoperative hypotension and was euthanized due to poor prognosis.

Limitations

This report describes a single case, limiting generalizability. Culture and cytologic evaluation of purulent material were not performed. Additionally, histopathologic confirmation of pancreatic necrosis was not obtained, and classification of the peripancreatic collection was based primarily on imaging and intraoperative findings.

Conclusions

This case documents the first reported instance of mechanical colonic obstruction secondary to acute necrotizing pancreatitis in a dog. Advanced imaging, particularly CT, was essential for identifying the spatial continuity of peripancreatic necrosis and colonic compression, clarifying the cause of obstruction despite improving laboratory markers. Clinicians should consider colonic obstruction as a rare but severe complication of pancreatitis, particularly in patients with delayed clinical recovery. Early advanced imaging may facilitate timely diagnosis and surgical intervention, although prognosis appears guarded to poor.

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