title: Pancreatico-mediastinal fistula with a mediastinal mass lesion demonstrated by MR imaging.
abstract: Internal pancreatic fistulas are uncommon but well-recognized complications of inflammatory pancreatic disease. A case of a pancreatico-mediastinal fistula with a mediastinal mass lesion in a patient with a documented history of chronic alcohol consumption and previous episodes of acute pancreatitis is described. Since the clinical symptomatology was dominated by pulmonary complaints, magnetic resonance (MR) imaging using a breathhold coronal T2-weighted sequence with spectral fat saturation was essential in clarifying this difficult and rare pathology. Furthermore, the depiction of a fistulous tract between a mediastinal mass lesion and the retroperitoneum posterior to the pancreas, i.e., a pancreatico-mediastinal fistula by MR imaging has not been previously reported, to the best of our knowledge.
authors.affiliation: Department of Diagnostic Radiology, University of Freiburg Medical Center, Freiburg im Breisgau, Germany. oeksuez@mrs1.ukl.uni-freiburg.de
authors.forename: Mehmet O
authors.initials: MO
authors.lastname: Oksüz
authors.forename: Carsten
authors.initials: C
authors.lastname: Altehoefer
authors.forename: Jan T
authors.initials: JT
authors.lastname: Winterer
authors.forename: Marisa
authors.initials: M
authors.lastname: Windfuhr-Blum
authors.forename: Manuela
authors.initials: M
authors.lastname: Kleinschmidt
authors.forename: Fritz
authors.initials: F
authors.lastname: von Weizsäcker
authors.forename: Andreas
authors.initials: A
authors.lastname: Ochs
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009336:Necrosis; D010185:Pancreatic Fistula / Q000175:diagnosis*; D019512:Pancreatitis, Alcoholic / Q000150:complications; D014057:Tomography, X-Ray Computed