Case 273: Pancreatic Duct-to-Portal Vein Fistula with Secondary Portal Vein Pyophlebitis-A Rare Complication of Chronic Pancreatitis

Radiology. 2020 Jan;294(1):234-237. doi: 10.1148/radiol.2019171373.

Abstract

HistoryA 55-year-old man with a history of chronic pancreatitis secondary to chronic alcohol abuse presented to the hospital with acute abdominal pain, generalized weakness, weight loss, and pyrexia. A clinical examination revealed he was tender to touch in the upper abdomen. Laboratory tests revealed a serum alkaline phosphatase level of 370 U/L (6.1 µkat/L) (normal range, 30-130 U/L [0.5-2.2 µkat/L]), a lipase level of 172 U/L (2.9 µkat/L) (normal range, 0-60 U/L [0-1.0 µkat/L]), a C-reactive protein level of 159 mg/L (1514 nmol/L) (normal value, <8.0 mg/L [76.2 nmol/L]), and a white cell count of 7 × 109/L (normal range, [4-11] × 109/L). During the present admission, the patient underwent urgent CT for his acute symptoms. His relevant medical history included a hospital admission 2 months earlier for abdominal discomfort. Given his history of chronic pancreatitis, baseline abdominal MRI was performed to determine the cause of his symptoms and to assess the pancreas.

Publication types

  • Case Reports

MeSH terms

  • Digestive System Fistula / diagnostic imaging*
  • Digestive System Fistula / etiology*
  • Digestive System Fistula / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pancreatic Ducts / diagnostic imaging*
  • Pancreatitis, Chronic / complications*
  • Phlebitis / diagnostic imaging*
  • Phlebitis / etiology*
  • Portal Vein / diagnostic imaging*
  • Stents
  • Tomography, X-Ray Computed