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表现为后纵隔肿块伴反复胸腔积液的胰腺纵隔假性囊肿:一例病例报告及文献复习

Pancreatic mediastinal pseudocyst presenting as a posterior mediastinal mass with recurrent pleural effusions: a case report and review of the literature.

作者信息

Karamouzos Vasilis, Karavias Dimitrios, Siagris Dimitrios, Kalogeropoulou Christina, Kosmopoulou Fay, Gogos Charalampos, Velissaris Dimitrios

机构信息

Internal Medicine Department, University Hospital of Patras, Rion, 26500, Greece.

General Surgery Department, University Hospital of Patras, Rion, 26500, Greece.

出版信息

J Med Case Rep. 2015 May 12;9:110. doi: 10.1186/s13256-015-0582-z.

Abstract

INTRODUCTION

A rare complication of chronic pancreatitis is the formation of single or multiple mediastinal pseudocysts, which are fueled from the pancreas through anatomical openings of the diaphragm. We present a rare case with a difficult diagnosis, treatment and potentially catastrophic complications.

CASE PRESENTATION

A 53-year-old Caucasian man was referred to our hospital for further investigation and treatment of a large heterogeneous mass situated in the posterior mediastinum, and bilateral pleural effusions which had developed after recent multiple episodes of pancreatitis. He had a history of chronic alcoholism. Laboratory and imaging modalities established the diagnosis of a pancreatic mediastinal pseudocyst.

CONCLUSIONS

Despite successful initial conservative treatment, our patient had a relapse and underwent emergency surgical intervention due to internal hemorrhage. We present his diagnostic and imaging workup, along with the multidisciplinary intervention, and a literature review referring to the diagnosis and treatment of mediastinal pancreatic pseudocysts.

摘要

引言

慢性胰腺炎的一种罕见并发症是形成单个或多个纵隔假性囊肿,这些囊肿通过膈肌的解剖开口由胰腺供血。我们报告一例诊断、治疗困难且可能出现灾难性并发症的罕见病例。

病例介绍

一名53岁的白种男性因后纵隔巨大不均质肿块及近期多次胰腺炎发作后出现的双侧胸腔积液被转诊至我院进一步检查和治疗。他有慢性酒精中毒史。实验室检查和影像学检查确诊为胰腺纵隔假性囊肿。

结论

尽管最初保守治疗成功,但我们的患者复发,因内出血接受了急诊手术干预。我们介绍了他的诊断和影像学检查过程、多学科干预措施,并对纵隔胰腺假性囊肿的诊断和治疗进行了文献综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f9/4481071/5d858122a499/13256_2015_582_Fig1_HTML.jpg

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