Korean J Med.  2014 Oct;87(4):455-460. 10.3904/kjm.2014.87.4.455.

Pancreaticopleural Fistula Treated by Endoscopic Pancreatic Stenting in a Patient with Recurrent Pancreatitis

• Kwon H
• Lee J
• Choi E
• Kim H
• Choi JH
• Byun JH
• Kim MH

• KMID: 2269221
• DOI: http://doi.org/10.3904/kjm.2014.87.4.455

Abstract

Pancreatic duct disruption associated with pancreatitis can lead to the development of pseudocysts, pancreatic ascites, and pleural effusion. A 50-year-old male presented with a 1-month history of postprandial epigastric pain. A chest X-ray showed right pleural effusion. Diagnostic thoracentesis revealed an amylase-rich exudate consistent with pancreatic effusion. Magnetic resonance cholangiopancreatography demonstrated a pancreaticopleural fistula tract, and endoscopic retrograde pancreatography confirmed the presence of pancreatic ductal disruption and leakage at the genu portion. The pancreaticopleural fistula was treated by transpapillary pancreatic stenting. Percutaneous drainage of the pleural effusion and octreotide injection were also performed. Follow-up endoscopic retrograde pancreatography at 8 weeks revealed no leakage of contrast media from the main pancreatic duct. Endoscopic pancreatic stenting can be an efficacious nonsurgical treatment of pancreaticopleural fistula following pancreatitis.

Keyword

Pancreatitis; Pancreaticopleural fistula; Pleural effusion

MeSH Terms

Ascites
Cholangiopancreatography, Magnetic Resonance
Contrast Media
Drainage
Exudates and Transudates
Fistula*
Follow-Up Studies
Humans
Male
Middle Aged
Octreotide
Pancreatic Ducts
Pancreatic Pseudocyst
Pancreatitis*
Pleural Effusion
Stents*
Thorax
Contrast Media
Octreotide