DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.065

Pages: 1143-1146

Intraductal papillary mucinous neoplasms (IPMNs) are cystic pancreatic tumors with malignant potential. Fistulization into adjacent organs, including the stomach, is a rare but recognized complication. Imaging plays a pivotal role in diagnosis and management. We report a 52-year-old patient presenting with chronic epigastric pain and unremarkable laboratory findings. Computed tomography (CT) revealed a multiloculated cystic lesion in the pancreatic head. Magnetic resonance cholangiopancreatography (MRCP) demonstrated a multilocular lesion communicating with a dilated main pancreatic duct. A fistulous tract connecting the lesion to the gastric lumen was identified as well as on ultrasound. This case highlights the crucial role of multimodal imaging in diagnosing IPMN complicated by pancreatico-gastric fistula. Recognition of imaging patterns is essential for early detection and appropriate management.