Bustamante Bernal Marco Antonio, Gonzalez Martinez Jose Lisandro, Ortiz Arleen, Zuckerman Marc J
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA.
Department of Internal Medicine, Division of Gastroenterology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA.
Am J Case Rep. 2017 Jul 5;18:750-753. doi: 10.12659/ajcr.903925.
BACKGROUND Pancreatic-pleural fistula (PPF) is an uncommon complication of pancreatitis. Pleural effusions secondary to PPF are caused by fistulization of pancreatic secretions to the thorax derived from the rupture or leakage of a pseudocyst. CASE REPORT We describe the case of a 44-year-old male with recurrent right-sided pleural effusions and alcoholic pancreatitis who presented with epigastric pain and shortness of breath. Pleural fluid analysis revealed an amylase of 7002 U/lt. MRCP showed segmental narrowing and stricture of the proximal main pancreatic duct and an area of walled-off necrosis. The fistula was managed endoscopically with ERCP and placement of a plastic stent into the pancreatic duct. The pleural effusion resolved and subsequent examinations showed no evidence of recurrence. CONCLUSIONS The diagnosis of PPF is challenging. Endoscopic treatment of PPF can be a safe and effective approach.
背景 胰胸膜瘘（PPF）是胰腺炎的一种罕见并发症。PPF继发的胸腔积液是由胰腺分泌物经假性囊肿破裂或渗漏进入胸腔形成瘘管所致。病例报告 我们描述了一名44岁男性患者，患有复发性右侧胸腔积液和酒精性胰腺炎，表现为上腹部疼痛和呼吸急促。胸腔积液分析显示淀粉酶为7002 U/lt。磁共振胰胆管造影（MRCP）显示主胰管近端节段性狭窄和狭窄以及一个包裹性坏死区域。通过内镜逆行胰胆管造影（ERCP）对瘘管进行处理，并在胰管内放置塑料支架。胸腔积液消退，后续检查未发现复发迹象。结论 PPF的诊断具有挑战性。内镜治疗PPF可以是一种安全有效的方法。
