Wypych Katarzyna, Serafin Zbigniew, Gałązka Przemysław, Strześniewski Piotr, Matuszczak Włodzimierz, Nierzwicka Katarzyna, Lasek Władysław, Prokurat Andrzej I, Bąk Marek
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Pol J Radiol. 2011 Apr;76(2):56-60.
Pancreaticopleural fistula (PPF), a form of internal pancreatic fistula, is a rare complication of acute or chronic pancreatitis or pancreatic trauma.
We report two cases of PPF resulting in formation of pleural pancreatic pseudocysts. A 35-year-old male alcoholic patient with a history of recurrent episodes of acute pancreatitis was admitted due to a severe dyspnea. A CT scan showed a significant left pleural effusion with a total left lung atelectasis, compression of the mediastinum, and dislocation of the left diaphragm. A follow-up CT showed a fistula between the abdominal pancreatic pseudocyst and the left pleural cavity. The second case was a 13-year-old male patient, who was admitted for a splenic stump excision. Two weeks after the surgery the patient presented a massive pleural amylase-rich effusion. CT exam suggested a PPF, which was indirectly confirmed by a thoracoscopy.
PPF should be considered in cases of massive pleural effusion and encapsulated pleural fluid collections in patients with a history of acute pancreatitis and surgery involving pancreas.
胰胸膜瘘（PPF）是胰内瘘的一种形式，是急性或慢性胰腺炎或胰腺创伤的罕见并发症。
我们报告两例导致胸膜胰腺假性囊肿形成的PPF病例。一名35岁有复发性急性胰腺炎病史的男性酒精性患者因严重呼吸困难入院。CT扫描显示左侧大量胸腔积液伴左肺完全肺不张、纵隔受压和左膈移位。随访CT显示腹腔胰腺假性囊肿与左胸腔之间存在瘘管。第二例是一名13岁男性患者，因脾残端切除入院。术后两周患者出现大量富含淀粉酶的胸腔积液。CT检查提示PPF，胸腔镜检查间接证实了这一点。
对于有急性胰腺炎病史且接受过涉及胰腺手术的患者，出现大量胸腔积液和包裹性胸腔积液时应考虑PPF。
