Sun S L, Guo H J, Li X, Chen B Y, Zhao H Y
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2025 Aug 12;48(8):748-751. doi: 10.3760/cma.j.cn112147-20250404-00183.
Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis that is often overlooked in the initial differential diagnosis of pleural effusion, resulting in delays to diagnosis and treatment. This manuscript reported a case of a patient with recurrent hemorrhagic pleural effusion, in whom markedly elevated levels of amylase and lipase in the pleural fluid led to a diagnosis of pancreaticopleural fistula via magnetic resonance cholangiopancreatography (MRCP). This case aimed to raise awareness among clinicians about the importance of considering uncommon etiologies in the differential diagnosis of pleural effusion, and highlights the significance of elevated amylase levels in pleural fluid for the diagnosis of pancreaticopleural fistula. Although there is a lack of clear treatment guidelines for this disease, treatment typically involves addressing the underlying disease. Placement of stents through endoscopic retrograde cholangiopancreatography (ERCP) is also a feasible method, and early diagnosis and treatment can prevent long-term complications or mortality.
胰胸膜瘘（PPF）是慢性胰腺炎的一种罕见并发症，在胸腔积液的初始鉴别诊断中常被忽视，导致诊断和治疗延迟。本文报告了一例复发性出血性胸腔积液患者，其胸腔积液中淀粉酶和脂肪酶水平显著升高，通过磁共振胰胆管造影（MRCP）诊断为胰胸膜瘘。该病例旨在提高临床医生对胸腔积液鉴别诊断中考虑罕见病因重要性的认识，并强调胸腔积液中淀粉酶水平升高对胰胸膜瘘诊断的意义。尽管该病缺乏明确的治疗指南，但治疗通常包括处理基础疾病。通过内镜逆行胰胆管造影（ERCP）放置支架也是一种可行的方法，早期诊断和治疗可预防长期并发症或死亡。
