Delayed internal pancreatic fistula with pancreatic pleural effusion postsplenectomy.
The occurrence of pancreatic pleural effusion, secondary to an internal pancreatic fistula, is a rare clinical syndrome and diagnosis is often missed. The key to the diagnosis is a dramatically elevated pleural fluid amylase. This pancreatic pleural effusion is also called a pancreatic pleural fistula. It is characterized by profuse pleural fluid and has a tendency to recur. Here we report a case of delayed internal pancreatic fistula with pancreatic pleural effusion emerging after splenectomy. From the treatment of this case, we conclude that the symptoms and signs of a subphrenic effusion are often obscure; abdominal computed tomography may be required to look for occult, intra-abdominal infection; and active conservative treatment should be carried out in the early period of this complication to reduce the need for endoscopy or surgery.
Jin
Shu-Guang
SG
Department of Hepato-Bilio-Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Chen
Zhe-Yu
ZY
Yan
Lu-Nan
LN
Zeng
Yong
Y
D000681:Amylases / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000150:complications*; D010996:Pleural Effusion / Q000209:etiology*; D011183:Postoperative Complications; D013156:Splenectomy / Q000009:adverse effects*
D000681:Amylases