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. 2012:13:47-50.
doi: 10.12659/AJCR.882600. Epub 2012 Mar 20.

Pancreatic choledochal fistula complicating acute pancreatitis

Rahat Brar  1 , Iqbal Singh, Preetinder Brar, Abhishek Prasad, Rudra Prasad Doley, Jai Dev Wig
Affiliations

Pancreatic choledochal fistula complicating acute pancreatitis

Rahat Brar et al. Am J Case Rep. 2012.

Abstract

Background: Biliary tract involvement in acute necrotizing pancreatitis is rare.

Case report: We report a case of a 53-year-old man who had a pancreatic choledochal fistula complicating acute necrotizing pancreatitis. The fistula was suspected at computed tomography and confirmed at surgery. The patient underwent necrosectomy, cholecystectomy and proximal biliary diversion. He is well at 1-year follow-up.

Conclusions: Simultaneous presence of air in the biliary tree and pancreatic collection is highly suggestive of a pancreaticobiliary fistula. Pancreatic necrosectomy and proximal biliary diversion resulted in closure of the fistula.

Keywords: acute necrotizing; computed tomography; fistula; pancreatitis; pneumobilia.

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Figures

Figure 1
Figure 1
Axial contrast enhanced CT (CECT) sections showing air in the biliary radices (marked by arrows).
Figure 2
Figure 2
Coronal CECT sections showing the course of the Common Bile Duct opening into the pancreatic abscess.
Figure 3
Figure 3
Axial (CECT) sections showing the course of the Common Bile Duct and its communication with the pancreatic abscess.
See this image and copyright information in PMC

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