Saugier B, Emonot A, Berard P, Faguer P, Galy P
Poumon Coeur. 1976;32(5):233-40.
The pleurisies rich in amylase of the chronic pancreatitis and of pancreatic pseudo-cysts, studied in 20 cases, are quite unfrequent (0.5% of pleurisies of all kinds in the medical milieu). A pseudo-cyst was found 12 times out of 20 and a chronic pancreatitis without pseudocyst was found 8 times out of 20. Pleural effusion has a definite diagnostic valve, because in 70% of cases pancreatopathy cannot be recognized before it happens. The pleural liquid is rich in proteins and haemorrhagic in 2/3 of cases and its amylasic activity is either high or very high. Amylase level in pleural liquid is usually superior to amylasemia. The injection of lipiodol in the pleural cavity enables the visualization of a transdiaphragmatic fistula but this examination is not always well tolerated. The preoperatory cystography can opacify the pleura. In the absence of pseudo-cyst, medical treatment can dry the pleurisy in 70% of cases but does not modify the evolution of the pancreatic affection which will require surgery. Where a pseudo-cyst is concerned, surgery will often and quickly be the remedy.
对20例慢性胰腺炎和胰腺假性囊肿富含淀粉酶的胸膜炎进行研究，发现其相当少见（占医疗环境中各类胸膜炎的0.5%）。20例中有12例发现假性囊肿，20例中有8例发现无假性囊肿的慢性胰腺炎。胸腔积液具有明确的诊断价值，因为70%的病例在胰腺炎发病前无法确诊。胸腔积液富含蛋白质，2/3的病例为血性，其淀粉酶活性高或极高。胸腔积液中的淀粉酶水平通常高于血淀粉酶水平。向胸腔内注入碘油可显示膈下瘘，但该检查并非总能被很好耐受。术前膀胱造影可使胸膜显影。在无假性囊肿的情况下，药物治疗可使70%的胸膜炎消退，但不能改变胰腺疾病的进展，胰腺疾病仍需手术治疗。对于假性囊肿，手术往往是快速有效的治疗方法。
