Gastrocutaneous fistulas associated with pancreatic abscesses. An aggressive entity.

摘要: Previous reports of gastrocutaneous fistulas emphasize their benign nature and the probability spontaneous healing without need for surgical closure. In distinct contrast we report our experiences with six patients whose were caused by fulminant pancreatitis pancreatic abscesses. High-output acid appeared days to weeks after drainage left upper quadrant-infected collections. None occurred at time initial abscess drainage. Most originated high on greater curvature stomach traversed cavity. Three had previous splenectomies, but these operations remote in from appearance fistula. Nonoperative management was successful only two patients. Massive hemorrhage fistula tract contributed deaths three The pathogenesis appears be consequent gastric injury resulting adjacent inflammation. We conclude that (1) associated are unlikely heal even abscesses often complicated hemorrhage, (2) closure will necessary should not unreasonably delayed, (3) when performed a semi-elective setting, resection damaged segment, perhaps an omental or serosal patch buttress suture line, has good chance success.