Duncan Newton D, Ramphal Paul S, Dundas Simone E, Gandreti Nischal K, Robinson-Bridgewater Lilieth A, Plummer Joseph M
Department of Surgery, University Hospital of the West Indies, Kingston, Jamaica.
J Pediatr Surg. 2006 Mar;41(3):580-2. doi: 10.1016/j.jpedsurg.2005.11.082.
Pancreaticopleural fistula resulting in a chronic pleural effusion is a rare complication of pancreatic duct disruption. We describe the presentation and management of 2 children with pancreaticopleural fistulas. Pleural fluid amylase concentration and contrast computed tomography were sufficient to establish the diagnosis in both cases. The initial management of these fistulas should be conservative, by tube thoracostomy and suppression of pancreatic secretion. Operative treatment is necessary for those who fail to resolve. Complete diversion of the pancreatic juice into the gastrointestinal tract by longitudinal pancreaticojejunostomy has been an effective surgical option leading to fistula closure.
胰胸膜瘘导致慢性胸腔积液是胰管破裂的一种罕见并发症。我们描述了2例胰胸膜瘘患儿的临床表现及治疗情况。胸腔积液淀粉酶浓度及对比增强计算机断层扫描足以确诊这两例病例。这些瘘的初始治疗应采取保守方法，即胸腔闭式引流及抑制胰腺分泌。对治疗无效者则需手术治疗。通过纵向胰空肠吻合术将胰液完全转流至胃肠道是一种有效的手术选择，可使瘘闭合。
