title: Benign intraductal papillary-mucinous neoplasm of the pancreas associated with spontaneous pancreaticogastric and pancreaticoduodenal fistulas.
abstract: Invasive intraductal papillary-mucinous neoplasms (IPMNs) of the pancreas may be associated with pancreaticogastric fistulas as shown by case reports. We report the case of a benign IPMN associated with pancreaticogastric and pancreaticoduodenal fistulas. A 70-year-old woman was admitted with intestinal obstruction. Computed tomography and MRI showed a large dilatation of the main pancreatic duct (>1 cm) with intraductal nodules, and pancreaticogastric and pancreaticoduodenal fistulas. Several features in imaging were present to support a malignant IPMN, so that the patient underwent a pancreaticoduodenectomy. The histopathological examination of the surgical specimen showed a benign IPMN. This case proves that a benign IPMN can cause pancreaticogastric and pancreaticoduodenal fistulas, probably resulting from mechanical factors.
authors.affiliation: Department of Adults Radiology, University Brabois Hospital, Vandoeuvre les Nancy, France.
authors.forename: F
authors.initials: F
authors.lastname: Jausset
authors.forename: M
authors.initials: M
authors.lastname: Delvaux
authors.forename: D
authors.initials: D
authors.lastname: Dumitriu
authors.forename: A
authors.initials: A
authors.lastname: Bressenot
authors.forename: O
authors.initials: O
authors.lastname: Bruot
authors.forename: J
authors.initials: J
authors.lastname: Mathias
authors.forename: D
authors.initials: D
authors.lastname: Regent
authors.forename: V
authors.initials: V
authors.lastname: Laurent
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000150:complications* / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000150:complications* / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology* / Q000601:surgery; D005260:Female; D005747:Gastric Fistula / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D010185:Pancreatic Fistula / Q000209:etiology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000601:surgery; D016577:Pancreaticoduodenectomy