Elderly male patient with gastrocolic fistula following severe acute necrotising pancreatitis

Plain CT images (figure 1A,B) demonstrated mild inflammatory changes in the perigastric and paripancreatic regions with possible fistulous communication between the body of stomach and transverse colon. (A) Images of contrast-enhanced CT performed 2 months ago, (A,B) pre-contrast CT images demonstrating multiple air foci within the gastric emphysema (black arrows) and necrotic peripancreatic collection (white arrow). GCF presenting with gastrointestinal haemorrhage requires prompt intervention.5 7 12 GCF closure via over-the-scope clip system, human fibrin sealant and endoscopic closure has been tried with success.14 15 Colonic fistulas are associated with increased mortality,3 hence prompt diagnosis and treatment is required to prevent complications.