Colonic perforation during colonoscopy

✍ Scribed by R. M. Charnley; G. Campbell; M. H. Robinson; P. Rooney

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 145 KB
• Volume: 79
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800790341

✦ Synopsis

Sir

We read with great interest the article on chronic pancreatitis by Jalleh et al. (Br J Surg 1991; 78: 1235-7) and agree with the logical policy of excision of the most severely affected part of the gland. However, although in their discussion they suggest that the recordings of 'pancreatic tissue pressure' may reflect parenchymal density rather than intracavity hydrostatic pressure, they do not stress that they are simply measuring the compliance of the tissue and not the hydrostatic pressure. We suggest that the very high readings that they obtained in severely diseased areas of the pancreas merely reflect the degree of fibrosis and calcification, as seen on the computed tomography scan, and not raised pancreatic tissue pressure. Surely if the gland has a tissue pressure of 200 mmHg and the duct has a pressure of only 20 mmHg then the duct is hardly likely to be dilated. The concept, therefore, of a 'compartment syndrome' cannot be justified on these data.