Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK.
HPB (Oxford). 2004;6(1):37-40. doi: 10.1080/13651820310015789.
Pancreatico-bronchial fistulas are a rare complication of acute or chronic pancreatitis. Both conservative and surgical management have been described previously.
The management of a 68-year-old woman with acute pancreatitis complicated by a pancreatico-bronchial fistula was reviewed. CT scanning and magnetic resonance cholangio-pancreatography demonstrated a pancreatic pseudocyst with extension into the posterior mediastinum and right pleura. Despite conservative management as well as ERCP with pancreatic stent insertion, the fistula failed to resolve. Successful management of this difficult problem was achieved with distal pancreatectomy and intercostal drainage.
Pancreatico-bronchial fistulas may be managed conservatively, but there should be a low threshold for surgical intervention if endoscopic measures fail.
胰支气管瘘是急性或慢性胰腺炎的罕见并发症。此前已经描述了保守治疗和手术治疗。
对一名 68 岁女性的病例进行了回顾，该患者患有急性胰腺炎并伴有胰支气管瘘。CT 扫描和磁共振胰胆管造影显示胰腺假性囊肿延伸至后纵隔和右胸膜。尽管进行了保守治疗以及内镜逆行胰胆管造影和胰管支架置入术，但瘘管仍未愈合。通过远端胰腺切除术和肋间引流成功地解决了这个难题。
胰支气管瘘可以保守治疗，但如果内镜治疗失败，应及早考虑手术干预。
