A Case of Gastro-, Duodeno-, and Jejuno-Cutaneous Fistulas Followng Pancreatic Abscess

Iwao Ikai, Yasuo Matsutani, Toshio Kamata

Department of Surgery, The Taiju-kai Foundation General Hospital, Kaisei Byoin

A 33-year-old man, who had received a distal partial gastrectomy, underwent an emergency laparatomy with pancreatic drainage because of acute hemorrhagic pancreatitis. Two weeks later, a pancreatic abscess was diagnosed by CT scanning and fistulography. On the 54th post-operative day, gastro-, duodeno- and jejuno-cutaneous fistulas were detected on a fistulogram. After external drainage with systemic administration of antibiotics and total parenteral nutrition, the fistulas were closed. However, 3 weeks later, enlargement of the pancreatic abscess and enlargement of the pancreatic abscess and reappearance of gastro-and jejuno-cutaneous fistulas were observed. The patient was given a laparatomy with drainage of the pancreatic abscess and simple closure of the fistulas. The jejunal fistula remained, but it closed spontaneously in 6 weeks. This is a rare case of pancreatic abscess complicated with upper gastrointestinal fistulas.

Key words
acute pancreatitis, pancreatic abscess, enterocutaneous fistula

Reprint requests
Iwao Ikai Second Department of Surgery, Faculty of Medicine, Kyoto University
54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-01 JAPAN

Accepted
October 11, 1995

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