Successful percutaneous drainage with iodine irrigation for pancreatic fistulas and abscesses after necrotizing pancreatitis.

ABSTRACT

OBJECTIVE: To report an uncommon method of managing pancreatic fistulas and retroperitoneal abscess. CLINICAL PRESENTATION AND INTERVENTION A 50-year-old man was admitted with fever, abdominal pain, periumbilical fistula and pus in stool. Five months before admission, he underwent urgent necrosectomy (7 days after onset of pain) and subsequently two more surgeries for necrotizing pancreatitis. Ultrasound revealed fluid collection in the retropancreatic space. After evacuation of pus, contrast medium instilled through a catheter showed a retroperitoneal abscess cavity, retroperitoneal-periumbilical and retroperitoneal-sigmoidal fistulas. After percutaneous drainage and iodine irrigation, the abscess collection and fistulas disappeared. CONCLUSION: In this case, percutaneous drainage was a successful option in the management of pancreatic fistulas and a retroperitoneal abscess.