Pancreaticothoracic fistulas: imaging findings in five patients.
BACKGROUND
Pancreaticothoracic fistulas are a rare complication of chronic pancreatitis. This study evaluated the imaging findings in patients with pancreaticothoracic fistulas.


METHODS
We retrospectively reviewed the medical records and radiographic images in five patients with pancreaticothoracic fistulas diagnosed at our institution during the previous 6 years. Data from radiography, endoscopic retrograde cholangiopancreatography (ERCP), computed tomography (CT), magnetic resonance cholangiopancreatography, and drainage catheter studies were evaluated.


RESULTS
Persistent pleural effusions were present on the radiographs of all patients. ERCP was performed in three patients. Contrast material was injected into drainage catheters placed in a pancreatic pseudocyst in one patient and a pancreatic abscess in another patient. Pancreaticothoracic fistulas were demonstrated on all of these studies. One patient had a CT study immediately after ERCP and another patient had a CT study immediately after contrast material was injected through a drainage catheter placed percutaneously in a pseudocyst. CT demonstrated the full extent of the pancreaticothoracic fistula in both patients.


CONCLUSIONS
Pancreaticothoracic fistulas are rare and may require multiple imaging modalities to establish a diagnosis.
François
C J
CJ
Department of Radiology, Loyola University Medical Center, Maywood, IL 60153, USA.
Demos
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TC
Iqbal
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D000328:Adult; D001983:Bronchial Fistula / Q000175:diagnosis; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D005260:Female; D005402:Fistula / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000150:complications; D010496:Pericardium; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed