Back to the list
Congress: ECR26
Poster Number: C-25624
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. DUGAR, A. R. PATIL, S. Nandikoor, R. More, G. Pradeep; Bangalore/IN
Disclosures:
MEGHA DUGAR: Nothing to disclose
ARUNA R PATIL: Nothing to disclose
Shrivalli Nandikoor: Nothing to disclose
Radhika More: Nothing to disclose
Gautham Pradeep: Nothing to disclose
Keywords: Abdomen, Biliary Tract / Gallbladder, Pancreas, CT, MR-Cholangiography, Ultrasound, Cholangiography, Contrast agent-oral, Contrast agent-other, Fistula
Learning objectives To review the anatomy,etiology, classification, pathophysiology and management of various biliary and pancreatic fistulas. To demonstrate the imaging spectrum on CT and MRI/MRCP, highlighting direct and indirect signs across peritoneal, pleural, enteric, cutaneous, vascular, and bronchial fistulas. To highlight key imaging red flags for occult pancreatico-biliary fistulas in patients with refractory effusions, ascites, sepsis, or prolonged hospital stays. To compare the strengths and limitations of CT versus MRI/MRCP in delineating ductal anatomy and fistulous tracts. To emphasize the role of imaging in guiding management...
Read more Background Retrospectively reviewing cases diagnosed with biliary or pancreatic fistulas in our institution using CT and MRI as imaging modalities.
Read more Findings and procedure details The hepato-biliary and pancreatic system consists of the intrahepatic and extrahepatic bile ducts, gallbladder, and pancreatic ductal system, which converge at the ampulla of Vater under sphincter of Oddi control to deliver bile and pancreatic enzymes into the second part of the duodenum.Fig1 demonstrates the normal anatomy and some anatomical variants increasing predisposition to fistula formation.Pancreatico-biliary  fistulas are classified into external fistulas, where the pancreatic duct/bile duct communicates with the skin (cutaneous), and internal fistulas, where secretions drain into internal...
Read more Conclusion By combining detailed imaging with clinical insights, this study enhances timely diagnosis and early recognition of biliary and pancreatic fistulas, giving way for targeted intervention and early patient care.
Read more References   Cases from Apollo Hospitals, Banergatta Bangalore Chhabra M, Gupta P, Shah J, Samanta J, Mandavdhare H, Sharma V, Sinha SK, Dutta U, Kochhar R. Imaging diagnosis and management of fistulas in pancreatitis. Digestive Diseases and Sciences. 2024 Feb;69(2):335-48. Gurram RP, Harilal SL, Gnanasekaran S, Choudhury SR, Pottakkat B, Raja K. External pancreatic ductal stenting in minimally invasive pancreatoduodenectomy: How to do it?. Annals of hepato-biliary-pancreatic surgery. 2023 May 31;27(2):211-6. Ibrarullah MD, Mishra T, Das AP. Mirizzi syndrome. Indian Journal of Surgery. 2008...
Read more
GALLERY