Benign intraductal papillary-mucinous neoplasm of the pancreas associated with spontaneous pancreaticogastric and pancreaticoduodenal fistulas.
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.
Jausset
F
F
Department of Adults Radiology, University Brabois Hospital, Vandoeuvre les Nancy, France.
Delvaux
M
M
Dumitriu
D
D
Bressenot
A
A
Bruot
O
O
Mathias
J
J
Regent
D
D
Laurent
V
V
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