One of the most common causes of external pancreatic fistula is the iatrogenic manipulation of a complex pancreatic fluid collection concomitantly associated with a disconnected pancreatic duct [1,2]. This situation can lead to the development of a high output (up to 400mL/d) external pancreatic fistula that is difficult to manage and sometimes requires surgery [3]. In 2012, a 40-year-old woman...

liver abscess associated with transgastric migration of a self-expandable metallic stent Liver abscesses are usually drained percutaneously and if drainage is inadequate, surgery may be necessary [1]. Successful endoscopic ultrasound (EUS)-guided drainage has been described for abscesses located in the pancreas, pelvis, liver, and subphrenic space [2–4]. We report the first case of EUS-guided d...

Context Most of the pancreatic stents placed across pancreatojejunostomy at the time of Whipple procedure migrate spontaneously into the small bowel. Case report In this case series we present two patients with symptoms of abdominal pain, abnormal liver blood tests due to migration of pancreatic stents into the biliary tree through the choledochojejunostomy post Whipple surgery. Conclusion Thes...

The technique of pancreatic duct stenting during pancreatic anastomosis can markedly reduce the incidence of postoperative pancreatic fistula (PF) after pancreaticoduodenectomy (PD). The method of drainage includes using either an external or an internal stent; the meta-analysis result shows us that there were no differences in the rates of postoperative complications between PD using internal ...

Pancreatico-pericardial fistula is an extremely rare complication of chronic pancreatitis. We present a case of a 58-year-old man who presented with syncope. Transthoracic echocardiogram revealed a pericardial effusion with tamponade physiology. Pericardiocentesis and pericardial fluid analysis demonstrated a lipase level of 2321 U/L. Subsequently, an endoscopic retrograde cholangiopancreatogra...

A 50-year-old man was admitted to our department, complaining of epigastric pain and high fever. CT revealed a pseudocyst at the pancreatic head with upstream dilatation of the pancreatic duct (PD) and fluid collection surrounding the pancreas. Endosonography-guided PD drainage (ESPD) was performed because of unsuccessful ERCP. With a curved linear array echoendoscope, a 7.2 F catheter was plac...

- The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized p...

BACKGROUND & AIMS Plastic stents, placed via endoscopy to drain pancreatic fluid collections (PFCs), require repeat access. Covered metal stents are larger in diameter and can be inserted in a single step, but can migrate. We evaluated the safety and efficacy of a lumen-apposing, covered, self-expanding metal stent (LACSEMS) for PFC drainage. METHODS We performed a prospective study of the ou...

© 2012 Canadian Medical Association or its licensors CMAJ, March 6, 2012, 184(4) 433 A50-year-old man with chronic pancreatitis was admitted to hospital with increasing midabdominal pain, vomiting and weakness. His history included alcohol abuse, gastric resection and pancreatic pseudocyst. His hemoglobin level was 73 (normal 130– 170) g/L. Contrast-enhanced computed tomography (CT) showed a ma...

Introduction: Common causes of ascites include liver cirrhosis, heart failure, and malignancy. Pancreatic etiology is less common for ascites, but is most often a result of chronic pancreatitis secondary to alcoholic liver damage or pancreatic duct leak. Case description: The following case describes a patient with black-colored ascites secondary to pancreatic duct leak after total colectomy wi...