Pancreatic duct-portal vein fistula.
We describe a case of pancreatic duct-portal vein fistula discovered by endoscopic retrograde cholangiopancreatography, with confirmatory computed tomography and angiographic studies. The fistula was associated with chronic pancreatitis that was complicated by recurrent gram-negative bacteremia and peripheral subcutaneous fat necrosis, although pancreatic pseudocyst was not present. Even though surgical treatment was recommended, medical complications precluded surgery and the patient recovered with supportive therapy only. Follow-up endoscopic retrograde cholangiopancreatography showed spontaneous closure of the fistulous connection.
Gastroenterology Service, Walter Reed Army Medical Center, Washington, D.C.
S M
SM
Willis
T G
TG
Brewer
D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D005218:Fat Necrosis / Q000150:complications; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D010195:Pancreatitis / Q000150:complications; D011169:Portal Vein / Q000000981:diagnostic imaging; D018805:Sepsis / Q000150:complications