Massive ascites caused by intra-pancreatic arterioportal fistula: a rare complication of chronic pancreatitis

An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the po...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2017-02, Vol.10 (1), p.73-78
Main Authors: Yamazaki, Tomoo, Ochi, Yasuhide, Tanaka, Naoki, Watanabe, Takayuki, Iwaya, Yugo, Seki, Ayako, Hara, Etsuo, Tanaka, Eiji, Watanabe, Tomoharu, Imai, Shun, Hasebe, Osamu
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged, 80 and over
Arteriovenous Fistula - complications
Arteriovenous Fistula - diagnostic imaging
Arteriovenous Fistula - therapy
Ascites - diagnostic imaging
Ascites - etiology
Case Report
Colorectal Surgery
Embolization, Therapeutic - methods
Endoscopy, Gastrointestinal
Gastroenterology
Hepatic Artery - diagnostic imaging
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Pancreatic Fistula - complications
Pancreatic Fistula - diagnostic imaging
Pancreatic Fistula - therapy
Pancreatitis, Chronic - complications
Pancreatitis, Chronic - diagnostic imaging
Portal Vein - diagnostic imaging
Surgical Oncology
Tomography, X-Ray Computed
Ultrasonography
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Summary:An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst. Transarterial coil embolization dramatically improved the ascites. Arterioportal fistula and ensuing ascites should be recognized as a complication of chronic pancreatitis.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-016-0702-3