title: Massive ascites caused by intra-pancreatic arterioportal fistula: a rare complication of chronic pancreatitis.
abstract: An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst. Transarterial coil embolization dramatically improved the ascites. Arterioportal fistula and ensuing ascites should be recognized as a complication of chronic pancreatitis.
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan. ymzktm6@shinshu-u.ac.jp.|Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan. ymzktm6@shinshu-u.ac.jp.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Yamazaki
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ochi
authors.affiliation: Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan. naopi@shinshu-u.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Iwaya
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Seki
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Hara
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: Department of Diagnostic Radiology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Diagnostic Radiology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Imai
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hasebe
mesh_terms: D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Arterioportal fistula; Ascites; Chronic pancreatitis; Coil embolization