Pancreatopleural fistula as a complication of necrotizing pancreatitis (clinical case)
Keywords:acute pancreatitis, thoracoabdominal complications of acute pancreatitis, pancreatopleural fistula
Acute pancreatitis is a disease that is accompanied by systemic inflammatory response syndrome and polysystemic dysfunction. Often acute pancreatitis leads to damage to various organs, including: pleura, mediastinum, cardiovascular structures. These complications cause difficulties in diagnosing and treating patients. In this review, we discuss the complications of acute pancreatitis, focusing on the diagnosis and treatment of pancreatopleural fistulas. Pancreatopleural fistula is a rather rare complication observed in patients with both acute and chronic pancreatitis due to traumatic or iatrogenic damage to the pancreatic duct. Conservative treatment with ocreatid combined with stenting of the pancreatic duct currently makes it possible to achieve closure of the fistula in 31-45% of cases, surgical intervention – in 80-90% of cases. The clinical case presented in this article demonstrates the successful treatment of this difficult complication of acute pancreatitis. The authors emphasized the need for timely diagnosis of this condition, as delaying adequate treatment can worsen the prognosis of recovery of patients with pancreatopleural fistulae.
Peery AF, Crockett SD, Murphy CC, Jennifer LL, Evan SD, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology. 2019;156:254. doi: https://doi.org/10.1053/j.gastro.2018.08.063
Michael AM, Howard AR, Mark DG. Acute Pancreatitis. JAMA. 2021;325(4):382-90. doi: https://doi.org/10.1001/jama.2020.20317
Colvin SD, Smith EN, Morgan DE, Porter KK. Acute pancreatitis: an update on the revised Atlanta classification. Abdom Radiol (NY). 2020 May;45(5):1222-31. doi: https://doi.org/10.1007/s00261-019-02214-w
Ortiz Morales CM, Girela Baena EL, Olalla Muñoz JR, Parlorio de Andrés E, López Corbalán JA. Radiology of acute pancreatitis today: the Atlanta clas-sification and the current role of imaging in its diagnosis and treatment. Radiologia (Engl Ed). 2019 Nov-Dec;61(6):453-66. English, Spanish. doi: https://doi.org/10.1016/j.rx.2019.04.001
Luiken I, Eisenmann S, Garbe J, Sternby H, Verdonk RC, Dimova A, et al. Pleuropulmonary pa-thologies in the early phase of acute pancreatitis correlate with disease severity. PLoS One. 2022 Feb 7;17(2):e0263739. doi: https://doi.org/10.1371/journal.pone.0263739
Iyer H, Elhence A, Mittal S, Madan K, Garg PK. Pulmonary complications of acute pancreatitis. Expert Rev Respir Med. 2020 Feb;14(2):209-17. doi: https://doi.org/10.1080/17476348.2020.1698951
Katageri B, Rana SS, Bhatia A, Sharma RK, Gupta R. Serial lung ultrasound in the assessment of volume status and disease severity in acute pancreatitis. Gastro-enterology. 2018;154:S-103.51. doi: https://doi.org/10.1016/S0016-5085(18)30782-0
Tan JH, Chin W, Shaikh AL, Zheng S. Pancreatic pseudocyst: Dilemma of its recent management. Exp Ther Med. 2021 Feb;21(2):159. doi: https://doi.org/10.3892/etm.2020.9590
Silverman MB, Oliver JJ, Belcher CN, Wray J, Bridwell RE. Pancreaticopleural fistula, a rare mediastinal emergency. Am J Emerg Med. 2021 Jun;44:477.e1-477.e3. doi: https://doi.org/10.1016/j.ajem.2020.10.032
Chen Y, Jiang Y, Qian W, Yu Q, Dong Y, Zhu H, et al. Endoscopic transpapillary drainage in disconnected pancreatic duct syndrome after acute pancreatitis and trauma: long-term outcomes in 31 patients. BMC Gastro-enterol. 2019 Apr 16;19(1):54. doi: https://doi.org/10.1186/s12876-019-0977-1
How to Cite
Copyright (c) 2023 Medicni perspektivi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.