[Fistula between Wirsung and psoas muscle]

Area of Science:

• Gastroenterology and Hepatology
• Surgical Anatomy
• Minimally Invasive Surgery

Background:

• Pancreatic duct fistulas are uncommon, often presenting with complex symptoms.
• Fistulas involving the Wirsung duct and adjacent musculature are exceptionally rare.
• Accurate diagnosis is crucial for effective management.

Observation:

• A unique case of a fistula connecting the Wirsung duct (pancreatic duct) to the right psoas muscle is presented.
• The patient's primary symptoms were localized to the thigh.
• Initial diagnostic imaging revealed the unusual anatomical connection.

Findings:

• The Wirsung duct fistula was successfully treated using exclusively mini-invasive surgical techniques.
• Minimally invasive methods provided a definitive resolution of the patient's thigh-localized symptoms.
• This case highlights the feasibility of endoscopic or laparoscopic approaches for such rare fistulas.

Implications:

• This case expands the understanding of Wirsung duct fistula presentations and management.
• Mini-invasive techniques offer a viable and effective treatment strategy for rare pancreatic duct anomalies.
• Further research into minimally invasive options for complex fistulas is warranted.