Severe complications of mediastinal pancreatic pseudocyst: report of esophagobronchial fistula and hemothorax.
We report two patients with alcoholic pancreatic pseudocyst which communicated to the mediastinal space through the aortic hiatus, in one patient resulting in hypotensive shock due to hemothorax, and in the other, resulting in esophagobronchial fistula via the mediastinal cyst. The first patient was successfully treated by radical resection of the pancreatic body and tail, and the spleen, with an ultrasonic scalpel, although inflammatory changes caused by pancreatitis were so prominent that the splenic vein was occluded. The second patient could not be treated surgically, because the superior mesenteric vein had been occluded by chronic pancreatitis; he died of respiratory failure and sepsis due to aspiration pneumonia, despite receiving medical treatment.
Tanaka
A
A
Emergency Medicine, Kyoto University Hospital, 54 Kawaracho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan.
Takeda
R
R
Utsunomiya
H
H
Kataoka
M
M
Mukaihara
S
S
Hayakawa
K
K
D000328:Adult; D000437:Alcoholism / Q000150:complications; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002908:Chronic Disease; D004322:Drainage / Q000379:methods; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D006491:Hemothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D010192:Pancreatic Pseudocyst / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome