Pedicled intercostal muscle flap: a simple technique of closing pancreatico-pleural fistula from a thoracic approach

Abstract

A simple technique to close a pancreatico-pleural fistula in the course of thoracotomy and decortication for multiloculated empyema complicating acute haemorrhagic pancreatitis is described. Friable diaphragmatic tissue around the fistula made direct closure not a suitable option. The intercostal muscle flap of the thoracotomy space was mobilized on the anterior intercostal artery, tagged around the fistula into healthy diaphragmatic tissue. This simple technique was successful in closing the fistula and helping control the sepsis.