Korean J Gastrointest Endosc.  2000 Mar;20(3):231-234.

A Case of a Pancreaticobiliary Fistula Accompanied by Pancreatic Duct Stones

Affiliations
  • 1Department of Internal Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.

Abstract

A Pancreaticobiliary fistula is a rare complication of acute necrotizing pancreatitis or pancreatic abscess. One case is herein reported of pancreaticobiliary fistula that was found following removal of pancreatic duct stones by extracorporeal shock-wave lithotripsy and endoscopic sphincterotomy. The patient was a 53-year old woman who was admitted with epigastric pain and fever. Endoscopic retrograde pancreatography revealed multiple stones in the main pancreatic duct. Pus from the pancreatic duct was drained through the major papilla during cannulation. On balloon cholangiogram obtained after removal of the stones, a direct fistulous connection between the main pancreatic duct and distal common bile duct was noted. It is speculated that pancreatic abscess or mechanical compression of pancreatic duct stones may contribute to the destruction of the intrapancreatic bile duct, which leads to the formation of a pancreaticobiliary fistula.

Keyword

Pancreaticobiliary fistula; Pancreatic duct stone

MeSH Terms

Abscess
Bile Ducts
Catheterization
Common Bile Duct
Female
Fever
Fistula*
Humans
Lithotripsy
Middle Aged
Pancreatic Ducts*
Pancreatitis, Acute Necrotizing
Sphincterotomy, Endoscopic
Suppuration
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