Fistula associated to gastric prosthesis

A 51-year-old man with a history of decompressive surgery and endoscopic drainage with a transgastric metallic prosthesis on the posterior surface (Fig. 1, Red Arrow), due to encapsulated necrotizing pancreatitis. After 5 months and surgical drainage for abdominal abscesses, he was evaluated for fever and abdominal pain, and the CT revealed a collection in the abdominal wall (Fig. 1, asterisk) associated with a pancreatic fistulous tract (Fig. 1, white arrow). During scheduled surgery, a cutaneous-prosthetic-pancreatic fistulous tract was observed, guided by a nasogastric tube (Fig. 2a: White arrow). Distal spleno-pancreatectomy and prosthesis removal were performed (Fig. 2b), with satisfactory progress and discharge on the fourth postoperative day. A high index of suspicion is required to diagnose complications of endoscopic procedures.

Fig. 1

Fig. 2

The final diagnosis was enterocutaneous fistula associated with a transgastric prosthesis.

Funding

No funding was received for this publication.

Ethical considerations

The patient’s informed consent was obtained.

Conflict of interests

The authors have no conflict of interests to declare.