case_images: PMC1266404_01
case_images: ERCP on presentation showing a dilated MPD and cystic lesions in the distal region of the pancreas.
case_images: 1477-7819-3-70-1.jpg
case_images: PMC1266404_01_1477-7819-3-70-1.jpg
case_images: F1
case_images: ERCP confirmed these findings, and no extraluminal leakage of the contrast medium was observed (Figure 1).
case_images: Abdominal CT just prior to surgery showing distinct swelling of the pancreas and the gastric wall, causing the border between the two organs to be unclear.
case_images: 1477-7819-3-70-2.jpg
case_images: PMC1266404_01_1477-7819-3-70-2.jpg
case_images: F2
case_images: Distinct swelling of the pancreas and thickening of the gastric wall were subsequently observed by abdominal CT (Figure 2), which indicated a mild post-ERCP pancreatitis.
case_images: Gastroscopy just prior to surgery showing a small ulcer producing a mucinous discharge into the body of the stomach.
case_images: 1477-7819-3-70-3.jpg
case_images: PMC1266404_01_1477-7819-3-70-3.jpg
case_images: F3
case_images: Gastroscopy performed for the assessment of gastric wall thickness revealed a small ulceration in the body of the stomach (Figure 3), which was accompanied by a mucinous discharge suggesting the presence of a fistula opening into the MPD.
case_images: A cross-section of the pancreatogastric fistula (Hematoxylin and Eosin stain x 40). The fistula was significantly infiltrated with neutrophils and showed no evidence of neoplastic infiltration.
case_images: 1477-7819-3-70-4.jpg
case_images: PMC1266404_01_1477-7819-3-70-4.jpg
case_images: F4
case_images: Light microscopy examination revealed inflammatory cellular infiltration consisting mainly of neutrophils around a pancreatogastric fistula which had no neoplastic epithelia (Figure 4).