Endoscopic ultrasound-guided detection and internal drainage of a pancreato-cutaneous fistula after acute pancreatitis

Pancreatocutaneous fistulas are an uncommon complication of acute pancreatitis [1] [2]. Endoscopic management of these fistulas is not straightforward [3]. One approach involves catheterizing the fistula through the skin using a percutaneous drain; however, catheterization of the disconnected pancreatic duct is nearly impossible. Alternatively, pigtail drains can be placed in the peripancreatic collection, if present, but this cavity is often virtual and tends to empty through the cutaneous fistula [4] [5].