Pancreatico-bronchial Fistulae.

PANCREATIC fistula is not an uncommon condition. It usually presents externally at the site of surgical wounds following operations on the stomach, biliary tract, pancreas, left kidney and spleen. It also results from marsupialisation of false pancreatic cysts, and drainage of pancreatic abscesses. It may follow exploratory operations for trauma or inflammation of the pancreas. Desmond (1962) however states that the incidence of external fistula due to acute pancreatitis is considerably diminished today since the policy of conservative treatment has been established. Even when the routine policy was surgery, the occurrence of fistulae was slight, unless the pancreatic fascia was incised in many places. Its formation after marsupialisation is less frequent nowadays, because of the improved results obtained from internal drainage of the cyst into a loop of bowel. The majority of these fistule close spontaneously in due course (Borgstrom, 1961). Hunt (1954) estimated that 80% of them heal without further surgical intervention. The development of a bronchial fistula, in conjunction with an external fistula, is a very rare condition, according to its incidence recorded in the literature.