Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach

Figure 1 Endoscopic findings in the remnant stomach. A: Conventional endoscopic observation revealed a 15 mm elevated lesion in the remnant stomach. Furthermore, it produced a viscous, mucinous secretion; B: Observation using the indigo stain showed a superficial villous design and central dip.

Figure 2 Diagnosis of the villous elevated lesion as a fistula. A: Endoscopic ultrasonography with a 15-MHz mini-probe revealed a fistula from the central dip to the outside of the gastric wall (arrow); B: Fisterography by endoscopy showed the fistula of about 2 cm from the lesser curvature side of the remnant stomach (arrow); C: Computed tomogram just after fisterography showed the fistula between the pancreas tail and stomach (arrow).