Three-dimensional demonstration and endoscopic treatment of pancreaticoperitoneal fistula.
An alcoholic man presented with bloody ascites, which was confirmed as pancreatic ascites complicating chronic pancreatitis. Endoscopic retrograde pancreatography [ERP] demonstrated a ductal disruption at the head of the pancreas, a fistulous tract, and extravasation to the peritoneal cavity. Furthermore, a computerized tomographic scan subsequent to the endoscopic retrograde pancreatography (ERP-CT scan) gave the three-dimensional anatomy of the fistulous tract by the residual contrast media in the pancreatic duct and the fistulous tract. The pancreatic ascites, which was refractory to conventional medical treatment of a 5-wk duration, was successfully treated by endoscopic placement of a pancreatic stent and administration of a somatostatin analogue.
Shim
K S
KS
Department of Internal Medicine and Radiology, St. Vincent Hospital, Catholic University Medical College, Suwon, Korea.
Suh
J M
JM
Yang
Y S
YS
Choi
J Y
JY
Park
Y H
YH
D002760:Cholangiopancreatography, Endoscopic Retrograde; D003131:Combined Modality Therapy; D005402:Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010185:Pancreatic Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed
D015282:Octreotide