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CT Features of Pancreatic Fistula After Pancreaticoduodenectomy

Manabu Hashimoto1, Makoto Koga1, Koichi Ishiyama1, Jiro Watarai1, Satoshi Shibata2, Tutomu Sato2 and Yuzo Yamamoto2

1 Department of Radiology, Akita University School of Medicine, 1-1-1 Hondo, Akita, Akita 010-8543, Japan.
2 Department of Surgery, Akita University School of Medicine, Akita, Japan.


Figure 1
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  		Fig. 1A —CT in 49-year-old man 8 days after surgery shows pancreatic fistula that was confirmed by laparotomy and pancreaticojejunostomy and fluid collection around pancreaticojejunostomy. CT scan shows pancreaticojejunostomy site (large arrows). Note catheter used to stent pancreaticojejunostomy (small arrow) allows accurate identification of pancreatic anastomosis.

 

Figure 2
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  		Fig. 1B —CT in 49-year-old man 8 days after surgery shows pancreatic fistula that was confirmed by laparotomy and pancreaticojejunostomy and fluid collection around pancreaticojejunostomy. CT scan obtained just caudal to A shows fluid collection with air bubbles around pancreaticojejunostomy (white arrows). Fluid collection in pancreatic bed is also seen (black arrow).

 

Figure 3
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  		Fig. 2A —CT in 59-year-old man 16 days after surgery shows fluid collection around pancreaticojejunostomy. Pancreatic fistula was confirmed by pancreatography via stent catheter for pancreaticojejunostomy. CT scan shows fluid collection with air bubbles around pancreatic anastomosis (arrows).

 

Figure 4
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  		Fig. 2B —CT in 59-year-old man 16 days after surgery shows fluid collection around pancreaticojejunostomy. Pancreatic fistula was confirmed by pancreatography via stent catheter for pancreaticojejunostomy. CT scan obtained just cephalad to A shows fluid collection with air bubbles around pancreatic anastomosis (arrows).

 

Figure 5
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  		Fig. 3 —CT scan of 62-year-old man 7 days after surgery shows fluid collection in pancreatic bed (arrow). This patient had pancreatic fistula.

 

Figure 6
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  		Fig. 4 —CT scan of 70-year-old man 8 days after surgery shows fluid collection around hepaticojejunostomy site (arrow). This patient had no complications.

 

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