Pancreaticobronchial fistula with communication to a pseudoaneurysm of thesplenic artery in chronic pancreatitis

Thoracic manifestations of internal pancreatic fistulas caused by chronic p ancreatitis are rare conditions. The three main types of these manifestatio ns are mediastinal pseudocysts, pancreatico pleural fistulas and pancreatic obronchial fistulas. We report on one patient with the clinical presentatio n of all three thoracic internal pancreatic fistulas with a communication t o a pseudoaneurysm of the splenic artery caused by chronic alcohol-related pancreatitis. Conservative therapy over four weeks was not successful. Rese ction of talc pseudoaneurysm, debridement of the mediastinal pseudocyst and duodenum preserving resection of the pancreas treated all complications an d prevents recurrence in this patient with chronic pancreatitis.