Yeungnam Univ J Med.  2017 Dec;34(2):254-259. 10.12701/yujm.2017.34.2.254.

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula

• Park SH
• Park SK
• Kim SH
• Choi WK
• Shim BJ
• Park HU
• Jung CW
• Choi JW

• KMID: 2400363
• DOI: http://doi.org/10.12701/yujm.2017.34.2.254

Abstract

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia-disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

Keyword

Mediastinal mass; Pancreatic pseudocyst; Pancreatitis; Esophageal fistula

MeSH Terms

Abdomen
Adult
Chest Pain
Deglutition Disorders
Diagnosis
Endoscopy, Digestive System
Esophageal Fistula*
Fistula
Follow-Up Studies
Gastroscopy
Humans
Korea
Mediastinum
Methods
Pancreatic Diseases
Pancreatic Pseudocyst*
Pancreatitis
Pancreatitis, Chronic
Pleural Effusion
Pneumonia
Thorax