Pancreatobiliary and pancreatoduodenal fistulae in intraductal papillary mucinous neoplasm of the pancreas: report of a case.
Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas present more commonly in the elderly. This report describes a case of IPMN in a 36-year-old man who presented with obstructive jaundice and weight loss. The initial investigation by computed tomography scan revealed a cystic lesion in the head of pancreas fistulating into the duodenum and the common bile duct (CBD). Subsequent endoscopic retrograde cholangiopancreatography revealed a low CBD stricture with proximal filling defects. Mucin was observed extruding from the biliary orifice following an endoscopic sphincterotomy. A classic Whipple's pancreatoduodenectomy was performed to excise the lesion. A histological examination of the lesion confirmed the presence of a malignant IPMN of the pancreas complicated by pancreatobiliary and pancreatoduodenal fistulae.
Department of Surgery, UKM Medical Centre, Cheras, Kuala Lumpur, Malaysia.
Jan Jin
JJ
Bong
Jayson
J
Wang
Duncan R
DR
Spalding
D002288:Adenocarcinoma, Mucinous / Q000150:complications*; D000231:Adenocarcinoma, Papillary / Q000150:complications*; D000328:Adult; D001658:Biliary Fistula / Q000209:etiology*; D004378:Duodenal Diseases / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000150:complications*
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