Complete recovery after spontaneous drainage of pancreatic abscess into the stomach

Pancreatic abscess is a dreaded complication of acute pancreatitis, with a high death rate even with aggressive surgical treatment. We report two case s in which recovery followed spontaneous drainage into the stomach. A 75-ye ar-old woman with biliary pancreatitis and a 63-year-old man with ethanol-i nduced pancreatitis both developed pancreatic abscess, diagnosed by compute d tomography scans and ultrasound. The spontaneous gastric fistula was hera lded by a large emesis of purulent and necrotic material in one case and co pious nasogastric tube secretions of a similar material in the other. Defer vescence was immediate, and both patients went on to complete recovery with out any further interventions. Contrast studies showed the fistulae. It is concluded that in the event that a pancreatic pseudocyst spontaneously drai ns into the stomach a 'wait and see' policy should be adopted, and a favora ble outcome can be expected.