[Endoscopic fibrin gluing of a pancreatic duct fistula following acute pancreatitis].
METHODS
A 45-year-old patient was admitted because of frequent attacks of upper abdominal pain after food intake. The pain episodes had started shortly after a bout of acute pancreatitis. Physical examination was unremarkable except for mild pain on palpation of the left lower abdomen.


METHODS
Amylase and gamma-glutamyl transaminase activities as well as inflammatory parameters were slightly raised. Ultrasonography was suggestive of a circumscribed area of necrosis in the tail of the pancreas, a finding confirmed on endoscopic retrograde injection of contrast medium, which passed into the necrotic cavity via a fistula.


METHODS
The fistula failed to close during 12 days of conservative treatment (total parenteral nutrition; 2 g ceftizoxim twice daily; 1 ampoule somatostatin daily). In three sittings during 6 days, 1-2 ml fibrin glue injections were made by endoscopy retrogradely into the fistular passage resulting in its complete occlusion without any further complications.


CONCLUSIONS
A previously treatment-resistant pancreatic fistula can be successfully occluded by injection of fibrin glue by retrograde endoscopy, obviating surgical intervention with subsequent reduction in glandular capacity.
Engler
S
S
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen.
Dorlars
D
D
Riemann
J F
JF
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D015296:Ceftizoxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000627:therapeutic use*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications*; D010289:Parenteral Nutrition, Total
D002511:Cephalosporins; D015718:Fibrin Tissue Adhesive; D005765:Gastrointestinal Agents; D006728:Hormones; D015296:Ceftizoxime; D015282:Octreotide
Endoskopische Fibrinverklebung einer Pankreasgangfistel nach akuter Pankreatitis.