Walled-off necrosis with portal vein fistula and arterial bleeding successfully treated without collection drainage: A case report

Pancreatic portal vein fistula (PPVF) is a rare condition, often a complication of chronic pancreatitis, involving communication between a pancreatic collection and the portal vein. Early diagnosis is crucial to prevent severe complications, including portal vein thrombosis and hemorrhage. This case report presents a 62-year-old man with HIV and congestive heart failure who developed a PPVF following walled-off necrosis due to acute pancreatitis. Diagnosis of this complication resulted from abdominal pain secondary to splenic artery branch bleeding into the collection, which was treated by embolization. Despite systemic complications, the patient recovered without the need for walled off necrosis drainage. This case underscores the challenge and the importance of individualized treatment for PPVFs and its complications.