Department of Medicine, National Academy of Medical Sciences, Kathmandu, 44600, Nepal.
National Trauma Center, Kathmandu, 44600, Nepal.
J Med Case Rep. 2024 Mar 29;18(1):131. doi: 10.1186/s13256-024-04457-8.
Pancreaticopleural fistula is a rare complication of pancreatitis and poses diagnostic and therapeutic challenges. This case report sheds light on the unique challenges posed by pancreaticopleural fistula as a rare complication of pancreatitis. The aim is to contribute valuable insights to the scientific literature by presenting a case involving a middle-aged man with acute necrotizing pancreatitis and associated pleural effusion.
A 41-year-old Asian male with a history of pancreatitis and chronic alcohol use presented with severe dyspnea, chest pain, and left-sided pleural effusion. Elevated serum amylase lipase levels and imaging confirmed acute necrotizing pancreatitis with a computed tomography severity index of 8/10. Magnetic resonance cholangiopancreatography revealed pancreatic necrosis and pseudocyst formation and findings suggestive of pancreaticopleural fistula. The patient was then treated with octreotide therapy.
The management of pancreaticopleural fistula demands a comprehensive and individualized approach. Recognition guided by high clinical suspicion coupled with appropriate investigations and a careful balance between medical, endoscopic, and surgical interventions is crucial for achieving favorable outcomes. This case report adds to the scientific literature by providing insights into the complexities of pancreaticopleural fistula and emphasizing the importance of personalized strategies in its management.
胰性胸腔瘘是胰腺炎的一种罕见并发症，具有诊断和治疗方面的挑战。本病例报告阐明了胰性胸腔瘘作为胰腺炎罕见并发症所带来的独特挑战。旨在通过报告一例急性坏死性胰腺炎伴胸腔积液的中年男性病例，为科学文献提供有价值的见解。
一名 41 岁的亚洲男性，有胰腺炎和慢性酒精使用史，出现严重呼吸困难、胸痛和左侧胸腔积液。血清淀粉酶脂肪酶水平升高和影像学检查证实为急性坏死性胰腺炎，计算机断层扫描严重指数为 8/10。磁共振胰胆管成像显示胰腺坏死和假性囊肿形成，并有胰性胸腔瘘的表现。随后，患者接受了奥曲肽治疗。
胰性胸腔瘘的管理需要全面和个体化的方法。高度临床怀疑指导下的识别，结合适当的检查，并在药物、内镜和手术干预之间谨慎平衡，对于实现良好的结果至关重要。本病例报告通过提供对胰性胸腔瘘复杂性的见解，并强调在其管理中采用个性化策略的重要性，为科学文献增添了内容。
