Chronic pancreatitis complicated by pancreaticopericardial fistula

Abstract

Pancreaticopericardial fistula is an extremely rare complication of chronic pancreatitis with few reported cases. A 45‐year‐old man with a history of chronic pancreatitis presented with dyspnoea and chest pain. On examination, there were signs of pyrexia, tachycardia, tachypnoea and hypotension. Computed tomography and magnetic resonance imaging demonstrated a fistulous tract arising from the tail of the pancreas and extending through the diaphragmatic hiatus into the posterior mediastinum and the pericardial sac. Initial conservative treatment with antibiotics, octreotide (a somatostatin analogue), and nasojejunal feeding led to resolution of the fistula. The patient subsequently underwent an elective Roux‐en‐Y pancreaticojejunostomy 1 month later. The operation was performed without complication and he has remained symptom free during follow‐up. We present this rare complication of chronic pancreatitis and review the relevant literature.