Two Patients with Chronic Pancreatitis Complicated by a Pancreaticopleural Fistula.
Two patients presented with dyspnea and signs of chronic pancreatitis. Patient B had pleural effusion on chest X-ray. Patient A developed pleural effusion during the course of disease. On further analysis these pleural effusions showed elevated amylase concentrations. This finding suggested the diagnosis of a pancreaticopleural fistula which was confirmed by magnetic resonance cholangiopancreatography. Because of the distinct localization of the fistulas the patients were treated differently. In patient A an endoprosthesis was successfully placed in the pancreatic duct, and patient B underwent distal pancreatic resection. Considering the rarity of pancreaticopleural fistula, there is no consensus on diverse aspects of treatment, such as length of treatment with octreotide. However, a rationale for the distinction between fistulas suited for treatment with endoprosthesis or surgery seems to provide some grip.
Kiewiet
Jordy J S
JJ
Departments of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Moret
Marlous
M
Blok
Willem L
WL
Gerhards
Michael F
MF
de Wit
Laurens T
LT