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Massive ascites caused by intra-pancreatic arterioportal fistula: a rare complication of chronic pancreatitis

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Abstract

An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst. Transarterial coil embolization dramatically improved the ascites. Arterioportal fistula and ensuing ascites should be recognized as a complication of chronic pancreatitis.

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Acknowledgements

We thank Mr. Trevor Ralph for this editorial assistance.

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Authors and Affiliations

  1. Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan

    Tomoo Yamazaki, Yasuhide Ochi, Takayuki Watanabe, Yugo Iwaya, Ayako Seki, Etsuo Hara & Osamu Hasebe

  2. Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan

    Tomoo Yamazaki & Eiji Tanaka

  3. Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan

    Naoki Tanaka

  4. Department of Diagnostic Radiology, Nagano Municipal Hospital, Nagano, Japan

    Tomoharu Watanabe & Shun Imai

Authors
  1. Tomoo Yamazaki
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  2. Yasuhide Ochi
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  3. Naoki Tanaka
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  4. Takayuki Watanabe
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  5. Yugo Iwaya
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  6. Ayako Seki
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  7. Etsuo Hara
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  8. Eiji Tanaka
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  9. Tomoharu Watanabe
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  10. Shun Imai
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  11. Osamu Hasebe
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Corresponding authors

Correspondence to Tomoo Yamazaki or Naoki Tanaka.

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All authors declare that they have no conflict of interest.

Human/animal Rights:

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients or being included in the study.

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Yamazaki, T., Ochi, Y., Tanaka, N. et al. Massive ascites caused by intra-pancreatic arterioportal fistula: a rare complication of chronic pancreatitis. Clin J Gastroenterol 10, 73–78 (2017). https://doi.org/10.1007/s12328-016-0702-3

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  • DOI: https://doi.org/10.1007/s12328-016-0702-3

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