Pancreatic Fistula Extending into the Thigh Caused by the Rupture of an Intraductal Papillary Mucinous Adenoma of the Pancreas

Intern Med. 2017;56(3):307-313. doi: 10.2169/internalmedicine.56.7422. Epub 2017 Feb 1.

Abstract

We herein report the first case of a pancreatic fistula extending into the thigh caused by the rupture of an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. An 80-year-old man was suspected to have necrotizing fasciitis because of right femoral pain. Computed tomography showed fluid retention from the pancreatic head to the right iliopsoas muscle and an IPMN at the pancreatic head. The findings of endoscopic retrograde pancreatography led to the suspicion of a minor leak and a pancreatic stent was placed. The patient died due to an uncontrollable infection. A pathological autopsy showed a pancreatic fistula extending into the thigh that had been caused by the rupture of the IPMN.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / complications*
  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Adenocarcinoma, Mucinous / pathology
  • Aged, 80 and over
  • Carcinoma, Pancreatic Ductal / complications*
  • Carcinoma, Pancreatic Ductal / diagnostic imaging
  • Carcinoma, Pancreatic Ductal / pathology
  • Cholangiopancreatography, Endoscopic Retrograde
  • Diagnosis, Differential
  • Fatal Outcome
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pancreatic Fistula / diagnosis*
  • Pancreatic Fistula / etiology
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / pathology
  • Thigh / pathology
  • Tomography, X-Ray Computed