Zhao Chengsi, Yao Weijie, Wang Zuozheng
Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
Medicine (Baltimore). 2025 Jan 3;104(1):e41184. doi: 10.1097/MD.0000000000041184.
Pancreaticopleural fistula (PPF) is a rare but serious complication of pancreatic disease, typically resulting from the rupture of a pancreatic pseudocyst or ductal injury. The condition often leads to misdiagnosis due to its nonspecific clinical manifestations, including dyspnea and chest pain.
A 61-year-old male with a history of alcohol and tobacco use presented with severe dyspnea, chest pain, and cough. He had been diagnosed with acute pancreatitis 9 months prior and intermittently experienced upper abdominal pain and distension post-treatment.
PPF.
The patient underwent thoracic drainage, nasopancreatic duct drainage, and pancreatic duct stent placement, along with parenteral nutrition and somatostatin therapy.
Treatment resulted in resolution of pleural effusion and pseudocyst. The patient had no recurrence during a 5-year follow-up period.
This case demonstrates the effectiveness of a comprehensive treatment strategy combining thoracic and pancreatic drainage for PPF. Long-term follow-up is crucial for monitoring recurrence and assessing treatment efficacy. Future research should focus on optimizing treatment plans, particularly regarding the best timing for intervention and improving long-term outcomes.
胰胸膜瘘（PPF）是胰腺疾病一种罕见但严重的并发症，通常由胰腺假性囊肿破裂或导管损伤引起。由于其临床表现不具特异性，包括呼吸困难和胸痛，该病常导致误诊。
一名有酗酒和吸烟史的61岁男性，出现严重呼吸困难、胸痛和咳嗽。他在9个月前被诊断为急性胰腺炎，治疗后间歇性出现上腹部疼痛和腹胀。
PPF。
患者接受了胸腔引流、鼻胰管引流和胰管支架置入，同时接受肠外营养和生长抑素治疗。
治疗使胸腔积液和假性囊肿消退。患者在5年随访期内未复发。
本病例证明了胸腔和胰腺引流相结合的综合治疗策略对PPF的有效性。长期随访对于监测复发和评估治疗效果至关重要。未来的研究应专注于优化治疗方案，特别是关于最佳干预时机和改善长期预后。
