Murteira Fábio, Costa Tiago, Pinto Sara Barbosa, Francisco Elsa, Gomes Ana Catarina
Internal Medicine Departement, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
General Surgery Departement, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
J Cardiovasc Thorac Res. 2022;14(1):67-70. doi: 10.34172/jcvtr.2021.37. Epub 2021 Sep 6.
Pancreaticopleural fistulas (PPF) are a rare etiology of pleural effusions. We describe a case of a 61-year-old man, with left chest pain with six months of progression who presented with a large volume unilateral pleural effusion. A thoracentesis was performed, which showed a dark reddish fluid(exudate) and high content of pancreatic amylase. After that an abdominal computed tomography (CT)and magnetic resonance cholangiopancreatography (MRCP) was done, revealing fistulous pathways that originated in the pancreas. The patient was admitted for conservative and endoscopic treatment by Endoscopic Retrograde Cholangiopancreatography (ERCP) and a prosthesis was placed on a fistulous path. He was discharged without complications, with the resolution of the pleural effusion and fistula.The interest of this case lies in the rarity of the event and absence of symptoms of the probable primary event (acute pancreatitis). The possible iatrogenic association with several drugs of his usual medication makes it even more complex.
胰胸膜瘘（PPF）是胸腔积液的一种罕见病因。我们描述了一例61岁男性病例，其左侧胸痛持续进展6个月，出现大量单侧胸腔积液。进行了胸腔穿刺，抽出暗红色液体（渗出液），胰淀粉酶含量高。此后进行了腹部计算机断层扫描（CT）和磁共振胰胆管造影（MRCP），发现瘘管起源于胰腺。患者入院接受内镜逆行胰胆管造影（ERCP）的保守和内镜治疗，并在瘘管处放置了支架。患者出院时无并发症，胸腔积液和瘘管均已消退。该病例的意义在于该事件罕见，且可能的原发事件（急性胰腺炎）没有症状。其常用药物中几种药物可能存在医源性关联，这使得情况更加复杂。
