Spontaneous fistula of the abdominal wall with chronic pancreatitis, abscess formation, and calculi.

A BSCESS of the pancreas, pancreatic calculi and spontaneous fistula of the abdominal wall are seldom encountered. We observed all three phenomena simultaneously in one patient. Constant and/or paroxysmal pain, at times severe and often excrutiating, is a primary characteristic in the clinical syndrome of pancreatic calculosis and chronic pancreatitis. It is particularly pathognomonic of pancreatic calculi which cause pain by distending the small ducts. In our patient, a pancreatic abscess fistulized spontaneously through the anterior abdominal wall, accompanied by pancreatic calculosis in a chronic pancreatitis marked by the absence of pain.