Waki Shohei, Kubo Yujiro, Tao Hiroyuki
Department of Thoracic Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Japan.
Kyobu Geka. 2024 Jun;77(6):403-408.
Pancreatic pseudocysts rarely extend to the mediastinum and can be fatal if mediastinitis is complicated. In this report, we describe a case of mediastinitis associated with mediastinal pancreatic pseudocyst successfully treated by the thoracoscopic mediastinal drainage. The patient was a man in his 40s with a history of alcoholic acute pancreatitis. Chest and abdominal computed tomography (CT) scan taken for his complaints of back pain and dyspnea showed a pancreatic pseudocyst extending to the mediastinum. First, an endoscopic nasopancreatic drainage( ENPD) tube was placed, and then thoracoscopic mediastinal drainage was performed through the right thoracic cavity. After the operation, the pseudocyst in the mediastinum rapidly disappeared even though there was no drainage from the ENPD tube. Postoperative recovery of the patient was uneventful, and the patient was discharged on the 17th postoperatively day. This case suggests that the importance of prompt treatment for mediastinitis and the effectiveness of the thoracoscopic surgery.
胰腺假性囊肿很少延伸至纵隔,若并发纵隔炎则可能致命。在本报告中,我们描述了一例经胸腔镜纵隔引流成功治疗的与纵隔胰腺假性囊肿相关的纵隔炎病例。患者为一名40多岁男性,有酒精性急性胰腺炎病史。因背痛和呼吸困难进行的胸部和腹部计算机断层扫描(CT)显示胰腺假性囊肿延伸至纵隔。首先放置了内镜下鼻胰引流(ENPD)管,然后通过右侧胸腔进行胸腔镜纵隔引流。术后,尽管ENPD管没有引流,但纵隔内的假性囊肿迅速消失。患者术后恢复顺利,术后第17天出院。该病例提示了纵隔炎及时治疗的重要性以及胸腔镜手术的有效性。