A case of intraductal papillary mucinous neoplasm rupturing into both the bile duct and the abdominal cavity

Abstract

A 76-year-old man who was being followed due to a diagnosis of intraductal papillary mucinous neoplasm (IPMN) was admitted because of abdominal pain caused by tumor perforation. There was marked inflammation around the abscess, and a well-enhanced lesion was seen in the tumor on abdominal enhanced CT. While waiting to begin the operation, ERBD and ENBD were performed for cholangitis. The cytology of the mucinous bile from the ENBD was class III, and a biliopancreatic fistula was diagnosed. A pancreatoduodenectomy was performed. IPMN with focal invasive carcinoma and a neuroendocrine tumor were identified in the resected specimen. Pseudomyxoma peritonei should be watched for on follow-up.