Spontaneous gallbladder perforation and colon fistula in hypertriglyceridemia-related severe acute pancreatitis: A case report

Table 1 Laboratory examinations at admission

Test item	Test result	Reference range
White blood cell (× 109/L)	8.7	3.5-9.5
Hemoglobin (g/L)	78	120–160
Platelet (× 109/L)	206	100-350
Alanine aminotransferase (U/L)	230	9-50
Alkaline phosphatase (U/L)	67	45-125
Total bilirubin (μmol/L)	17.1	5.1-22.2
Conjugated bilirubin (μmol/L)	9.9	0-6.8
Potassium (mmol/L)	4.4	3.5-5.5
Serum urea (mmol/L)	19	2.78-7.14
Serum creatinine (μmol/L)	404	59-104
Creatine kinase (U/L)	42853	24-195
Myoglobin (μg/L)	88925	10-92
High-sensitivity C-reactive protein (mg/L)	> 250	< 3.0
Erythrocyte sedimentation rate (mm/h)	> 140	0-15
Procalcitonin (ng/mL)	16	< 0.25
Blood cultures	Negative	Negative

Table 2 Time course of this case

Time since SAP onset	Clinical events
11 d	Started jejunal nutrition
1 mo	Gallbladder perforation
	Percutaneous drainage
2 mo	Peripancreatic infection
	Antibiotics and percutaneous drainage
3 mo	Cholecysto-colonic fistula and descending colon fistula
	Peripancreatic debridement and ileostomy
4 mo	Normal body temperature
	Discharged from hospital
6 mo	Started oral intake
7 mo	All drains removed
10 mo	Cholecystectomy and ileostomy reversal
15 mo	Free from the symptoms after surgery

SAP: Severe acute pancreatitis.