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

ABSTRACT

To report an uncommon method of managing pancreatic fistulas and retroperitoneal abscess. 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. In this case, percutaneous drainage was a successful option in the management of pancreatic fistulas and a retroperitoneal abscess