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圭亚那一家地区医院收治的一例罕见的胰胸膜瘘,表现为反复胸腔积液。

A Rare Case of Pancreaticopleural Fistula That Presented as a Recurrent Pleural Effusion at a Regional Hospital in Guyana.

作者信息

Thakoordeen Ravinauth, Rampersaud Mahindra, Algu Tameshwar K

机构信息

General Surgery, New Amsterdam Regional Hospital, Berbice, GUY.

Department of Surgery, New Amsterdam Regional Hospital, Berbice, GUY.

出版信息

Cureus. 2024 May 30;16(5):e61357. doi: 10.7759/cureus.61357. eCollection 2024 May.

Abstract

Pancreaticopleural fistula is a rare complication of pancreatitis. We present a rare case of pancreaticopleural fistula in a 43-year-old alcoholic male. He presented with recurrent episodes of left pleural effusion that were managed with aspiration and chest tube placement. An MRI of the chest and upper abdomen revealed a pancreaticopleural fistula. The patient underwent distal pancreatectomy with splenectomy and Roux-en-Y pancreaticojejunostomy. The surgical approach was our first-line management due to the unavailability of octreotide and endoscopic retrograde cholangiopancreatography. His recovery was complicated by an empyema that was managed by tube thoracostomy and IV antibiotics. There was no issue detected at his 3-month follow-up clinic visit.

摘要

胰胸膜瘘是胰腺炎的一种罕见并发症。我们报告一例43岁男性酒精性胰腺炎患者发生胰胸膜瘘的罕见病例。患者反复出现左侧胸腔积液,通过胸腔穿刺抽液和放置胸腔引流管进行处理。胸部和上腹部的磁共振成像(MRI)显示存在胰胸膜瘘。由于无法获得奥曲肽且无法进行内镜逆行胰胆管造影术(ERCP),患者接受了远端胰腺切除术、脾切除术和Roux-en-Y胰空肠吻合术。手术治疗是我们的一线治疗方法。他的恢复过程因脓胸而复杂化,通过胸腔闭式引流术和静脉使用抗生素进行处理。在他术后3个月的门诊随访中未发现问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c1f/11214274/b909d1df5217/cureus-0016-00000061357-i01.jpg

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