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Korean J Med > Volume 87(4); 2014 > Article
The Korean Journal of Medicine 2014;87(4): 455-460.
내시경 췌관 스텐트 삽입술로 치료된 췌관-흉막루
권혜미1, 이지향1, 최은지1, 김효정1, 최준혁1, 변재호2, 김명환1
1울산대학교 의과대학 서울아산병원 내과
2울산대학교 의과대학 서울아산병원 영상의학과
Pancreaticopleural Fistula Treated by Endoscopic Pancreatic Stenting in a Patient with Recurrent Pancreatitis
Hyemi Kwon1, Jihyang Lee1, Eunji Choi1, Hyojung Kim1, Jun Hyuk Choi1, Jae Ho Byun2, Myung-Hwan Kim1
1Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Myung-Hwan Kim ,Tel: +82-2-3010-3183, Fax: +82-2-476-0824, Email: mhkim@amc.seoul.kr
Received: March 10, 2014;   Revised: April 7, 2014;   Accepted: May 15, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Pancreatitis; Pancreaticopleural fistula; Pleural effusion
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