Pancreaticopleural Fistula with Hemothorax.
10.4174/jkss.2009.76.3.187
- Author:
Young Hoon SUL
1
;
Hyoung Seob SHIN
;
Kyung Ha LEE
;
Kwang Sik CHUN
;
In Sang SONG
Author Information
1. Department of Surgery, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, Korea. Songis@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Pancreaticopleural fistula;
Hemothorax;
Distal pancreatectomy
- MeSH:
Alcoholism;
Amylases;
Drainage;
Dyspnea;
Fistula;
Gabexate;
Hemothorax;
Humans;
Male;
Mediastinum;
Middle Aged;
Octreotide;
Pancreas;
Pancreatectomy;
Pancreatic Pseudocyst;
Pancreatitis, Chronic;
Pleural Effusion;
Splenectomy;
Stents;
Thoracostomy;
Thorax
- From:Journal of the Korean Surgical Society
2009;76(3):187-191
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pancreaticopleural fistula is an uncommon complication of chronic pancreatitis. We report a case of pancreaticopleural fistula that was presented with right-sided hemothorax. A 49-year-old male with a history of chronic alcoholism was presented with a month of dyspnea. A chest radiography showed a right-sided massive pleural effusion with old-blood-colored fluids and amylase levels of 1,020 IU/L. On the chest computerized tomography (CT), there was pleural effusion and a well-defined tract from the posterior mediastinum to the pseudocyst in the tail of the pancreas. Even with conservative treatment with closed thoracostomy, octreotide and gabexate mesilate, he developed hemothorax. Abdominal CT revealed an increase of the hemorrhagic pancreatic pseudocyst. Distal pancreatectomy with splenectomy and external drainage of the pancreaticopleural fistula on the posterior mediasternum were performed. The patient had an uneventful course and was discharged on the 27th postoperative day. Management of pancreaticopleural fistula is multimodal included medication, endoscopic stenting and surgery. Surgery in pancreaticopleural fistula might be beneficial in selective cases.
