Spontaneous Healing of Pancreatic Abscess After Fistulization to the Duodenal Bulb

: A 70-year-old man was admitted to the hospital because of sudden, upper abdominal and back pain. Laboratory and image data indicated acute pancreatitis. Shortly after the admission, pancreatic and liver abscess with bacteremia developed. Antibiotic therapy seemed effective. A month later, spontane...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of the medical sciences 1997-07, Vol.314 (1), p.44-46
Main Authors: Kawachi, Shin-Ichi, Ogawa, Toru, Ukita, Masato, Shiroko, Junko, Kawase, Yasuhiko, Adachi, Saoashi, Kametani, Masaaki, Kamikubo, Keita
Format: Article
Language:English
Subjects:
Abscess - therapy
Aged
Biological and medical sciences
Diseases of the digestive system
Duodenal Diseases - diagnostic imaging
Gastrointestinal fistula
Humans
Intestinal Fistula - diagnostic imaging
Male
Medical sciences
Pancreatic abscess
Pancreatic Diseases - therapy
Pancreatic fistula
Pancreatic Fistula - diagnostic imaging
Pancreatitis
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Remission, Spontaneous
Tomography, X-Ray Computed
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:: A 70-year-old man was admitted to the hospital because of sudden, upper abdominal and back pain. Laboratory and image data indicated acute pancreatitis. Shortly after the admission, pancreatic and liver abscess with bacteremia developed. Antibiotic therapy seemed effective. A month later, spontaneous fistulization of the pancreatic abscess to the duodenal bulb was found by gastroduodenal fiberscopy. Injection of contrast medium into the duodenal orifice showed that the fistula was draining the abscess and that no other fistula formed from the abscess. Endoscopic retrograde cholangiopancreatogram indicated no fistula formation to the pancreatic duct. The pancreatic abscess became smaller and was not visible using computerized tomography and ultrasonography 3 months later and thereafter. Closure of the duodenal orifice was ascertained by the endoscopy. It is suggested that retrograde infection from the fistula was prevented by the single fistulization to the acidic duodenal bulb, which is not supposed to allow most bacterial growth. Pancreatic abscess usually necessitates operative treatment, even with fistulization to the alimentary tract. It seems likely that the single, small fistulization to the bulb, in addition to the lack of underlying disease and medical and nutritional support, facilitated the spontaneous healing process
ISSN:0002-9629
1538-2990
DOI:10.1016/S0002-9629(15)40156-9