一般社団法人日本呼吸器学会 公式サイト
日本呼吸器学会英文誌 Respiratory Investigation
日本呼吸器学会誌 増刊号 学術講演会プログラム 抄録集

Abstract

Full Text of PDF Full Text of PDF (656k)
Article in Japanese

Case Report

A case of pancreaticopleural fistula treated with pleurodesis and endoscopic nasopancreatic drainage

Masatsugu Ohuchia  Shuhei Inouea  Yoshitomo Ozakia  Yuki Namuraa  Keiko Uedab 

aDepartment of General Thoracic Surgery, National Hospital Organization, Higashi-Ohmi General Medical Center
bDepartment of Thoracic Surgery, Rakuwakai Otowa Hospital

ABSTRACT

A 59-year-old man with chronic pancreatitis and pancreatic pseudocysts presented a pleural effusion in the left thoracic cavity. Based on extremely high amylase levels in the serous effusion. Pancreatic pleural effusion was diagnosed. The chest radiograph showed reaccumulation of pleural effusion in the left thoracic cavity 4 months after drainage. As hemorrhagic pleural effusion had continued in spite of pleural drainage, octreotide therapy was instituted. Endoscopic retrograde cholangio-pancreatography (ERCP) showed irregularity of the pancreatic duct and leakage in the tail. Therefore, we diagnosed a pancreaticopleural fistula and an endoscopic nasopancreatic drainage (ENPD) tube was placed in the pancreatic duct to bridge the site of the irregularity. The chest tube was removed after chemical pleurodesis was performed. The ENPD tube was removed 3 weeks after the chest tube was removed. The fistula has not been proved to recur.

KEYWORDS

Pancreaticopleural fistula  Pancreatic pleural effusion  Thoracoscopy  Octreotide  Endoscopic nasopancreatic drainage (ENPD) 

Received 30 Jan 2018 / Accepted 24 Apr 2018

AJRS, 7(4): 267-271, 2018

Google Scholar