Korean J Hepatobiliary Pancreat Surg.  2013 May;17(2):75-78. 10.14701/kjhbps.2013.17.2.75.

Closure of pancreatoduodenal fistula using vascular occluding coil embolization and fibrin glue injection: a case study

• Choi KM
• Kim YD
• Ahn JH

• KMID: 1429983
• DOI: http://doi.org/10.14701/kjhbps.2013.17.2.75

Abstract

The conventional management of pancreatoenteric fistulas and pancreatic abscess with aggressive surgery or percutaneous drainage catheter placement are associated with increased surgery-related morbidity and mortality, and a longer hospitalization. We report here a case of successful closing pancreatoduodenal fistula, which remained open after the percutaneous catheter drainage of pancreatic abscess, by using vascular coil embolization and fibrin glue injection. This procedure is a less invasive, more effective and better tolerated strategy for the management of pancreatoenteric fistula in a selected group of high risk patients and needs further investigation.

Keyword

Pancreatoduodenal fistula; Embolization; Fibrin glue

MeSH Terms

Abscess
Catheters
Drainage
Fibrin
Fibrin Tissue Adhesive
Fistula
Hospitalization
Humans
Fibrin
Fibrin Tissue Adhesive

Figure

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  Fig. 1 Abdomen CT scan showing air-containing peripancreatic abscess (A). Pancreas swelling and infiltration were improved after percutaneous drainage (B).

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  Fig.2 Direct visualization of the two fistulous tracts between a pancreatic abscess and the medial side of duodenum.

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  Fig. 3 Esophagogastroduodenoscopic findings showing a fistulous hole (A) with pus draining into the duodenal wall (B).

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  Fig. 4 Abdomen CT scan showing improvement of peripancreatic abscess.

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  Fig. 5 Occlusion of the fistula tract with coils and fibrin glue.

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  Fig. 6 Follow-up esophagogastroduodenoscopic finding showing no recurrence of fistula.

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