Fistulation to the pancreatic duct complicating duodenal peptic ulcer.

A previously unreported complication of peptic ulcer disease is described--fistula formation between the duodenum and the pancreatic duct. Symptoms that initially were typical for ulcer disease changed abruptly in intensity, character, and timing when fistulation occurred. Diagnosis of this complication was elusive. Symptoms resolved completely after alimentary diversion by a Billroth II hemigastrectomy combined with truncal vagectomy.