We have recently published a case of spontaneous gastric decompression and resolution of an infected walled-off pancreatic necrosis (WOPN). According to the so-called “step-up approach”, which is a staged and multidisciplinary approach for the treatment of necrotizing pancreatitis, we have outlined the need of treating WOPN and their complications according to the clinical course of the patients and not only to radiological and laboratory findings. In the wake of these observations, we have recently observed another case of infected pancreatic necrosis complicated with fistulization not in the stomach, but in the duodenum, followed by complete resolution. So, in this work, we have described the case report and we have tried to make a brief revision of literature concerning treatment of gastrointestinal fistula complicating infected pancreatic necrosis, with particular regard to the “step-up” approach, used in our center.
Pancreatic necrosis, Duodenum fistula, Step-up approach