A rare case report of ascending colon perforation secondary to acute pancreatitis

•Knowledge about colonic perforation secondary to acute pancreatitis has been limited to a few case reports, thus diagnostic and management dilemmas continue to persist.•The exact pathogenesis by which pancreatic pseudocysts rupture into the colon is unknown. There have been several purported theories.•The management of colonic complications secondary to severe acute pancreatitis relies on a high index of suspicion, as the clinical presentation in non-specific, varied and can occur late in the disease process. Severe acute pancreatitis is associated with high morbidity and mortality. This is a result of the development of pancreatic and extra-pancreatic necrosis with subsequent infection which can lead to multiorgan failure. Complications include localized ileus, abscess formation, mechanical obstruction, rupture and perforation into the gastrointestinal tract and fistula formation (Aldridge et al., 1989; Bassi et al., 2001 [1,2]). A 72 year old man attended the emergency department with acute epigastric pain. Biochemistry results were reviewed with a lipase of 1680 U/L (ref range