The use of endoscopic retrograde choledocho pancreatography (ERCP) in the diagnosis of internal fistulae complicating severe acute pancreatitis.

Three patients are presented in whom internal pancreatic fistulae were accurately demonstrated by ERCP. It is recommended that this procedure be considered in the investigation of patients with continuing acute pancreatitis who are not settling on standard conservative treatment and in whom internal fistula formation is suspected. The procedure should also be considered in patients who present with unusual respiratory symptoms or with amylase-rich effusions.