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C-0839 - Pancreatic duct-portal vein fistula related to pancreatitis: Imaging features and clinical presentation

T. Tajima1, Y. Shida1, T. Okafuji2, K. Murakami1, M. Hotta1, T. Noguchi1, T. Iraha1, K. Yokoyama1, Y. Imamura1; 1 Tokyo/JP 2 Tokyu/JP Type: Scientific Exhibit
Area of Interests: Pancreas, Liver, Abdomen
Imaging Techniques: CT, MR
Procedures: Complications, Imaging sequences
Special Focuses: Fistula, Cysts, Inflammation
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Aims and objectives: As a rare complication of chronic pancreatitis, internal pancreatic fistulas are reported. There are many communicating sites of internal pancreatic fistulas such as portal system, biliary system, small intestine, colon, peritoneum and thoracic cavity. Pancreatic duct-portal vein fistula (PPF), a fi[...]

Methods and materials: Patients During 42 months (from September 2013 to September 2016), 223 patients (167 men and 56 women) who had a clinical diagnosis of pancreatitis received 391 CT examinations. Of these, there were six men with PPF (ages ranging from 46 to 80: mean, 57.7 years old) (2.7%) (Table 1). The background [...]

Results: Locations of PPF As for detailed locations of PPF in the six patients were shown in Table 2. The imaging modalities used for identification of PPF were as follows: CT in 2/6 and MRI in 5/6. The pancreatic sites of PPF were as follows: head in 3/6 and tail in 3/6. The portal vein sites of PPF were a[...]

Conclusion: Pathogenesis and imaging of segmental hepatic adiponecrosis In this study, segmental hepatic adiponecrosis was seen in a patient with PPF, and it showed a characteristic distribution in accord with the portal vein branches, was most clearly depicted in chemical shift MR imaging. To our knowledge, su[...]

Personal information: Tsuyoshi Tajima, MD, PhD: Department of Diagnostic Radiology, National Center for Global Health and Medicine. Yoshitaka Shida, MD: Department of Diagnostic Radiology, National Center for Global Health and Medicine. Takashi Okafuji, MD: Department of Diagnostic Radiology, National Center for Global H[...]

References: Skarsgard ED, Ellison E, Quenville N. Spontaneous rupture of a pancreatic pseudocyst into the portal vein. Can J Surg. 1995 Oct;38(5):459-63. Raza SS, Hakeem A, Sheridan M, Ahmad N. Spontaneous pancreatic pseudocyst-portal vein fistula: a rare and potentially life-threatening complication of pancrea[...]

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