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Summary <p>A 70-year-old male with recurrent alcohol-related pancreatitis and prior Roux-en-Y gastric bypass presented with complicated acute pancreatitis. Imaging revealed ascites, portal vein thrombosis with cavernous transformation, and a pancreatic pseudocyst adjacent to the portal vein. Subsequent MRCP demonstrated complete resolution of the thrombosis and confirmed a pancreatic–portal vein fistula (PPVF) with intravascular pancreatic secretions.</p> <p>Due to altered anatomy, endoscopic treatment was not feasible. A percutaneous approach was performed, including transhepatic drainage across the portal vein, pseudocyst, and pancreatic duct for decompression, followed by definitive portal vein embolization using an Amplatzer plug and Histoacryl/Lipiodol. At 4-month follow-up, MRI confirmed fistula closure and the patient remained clinically stable with preserved liver function.</p>

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Portal vein embolization for pancreatic-portal vein fistula in acute pancreatitis: interventional treatment of a rare complication

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月18日

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  • Maria M. Taepper,
  • Ricardo Donners,
  • Christoph Kümmerli,
  • Adrian Billeter,
  • Henriette S. Heinrich,
  • Marius Zimmerli,
  • Christoph J. Zech,
  • Adrian R. Kobe

摘要

Summary

A 70-year-old male with recurrent alcohol-related pancreatitis and prior Roux-en-Y gastric bypass presented with complicated acute pancreatitis. Imaging revealed ascites, portal vein thrombosis with cavernous transformation, and a pancreatic pseudocyst adjacent to the portal vein. Subsequent MRCP demonstrated complete resolution of the thrombosis and confirmed a pancreatic–portal vein fistula (PPVF) with intravascular pancreatic secretions.

Due to altered anatomy, endoscopic treatment was not feasible. A percutaneous approach was performed, including transhepatic drainage across the portal vein, pseudocyst, and pancreatic duct for decompression, followed by definitive portal vein embolization using an Amplatzer plug and Histoacryl/Lipiodol. At 4-month follow-up, MRI confirmed fistula closure and the patient remained clinically stable with preserved liver function.