胰腺胸膜瘘(PPF)是胸腔积液的罕见病因。我们描述了一个61岁男子的案例,左侧胸痛,进展6个月,出现大量单侧胸腔积液。进行了胸腔穿刺术,显示暗红色液体(渗出物)和高含量的胰腺淀粉酶。在完成腹部计算机断层扫描(CT)和磁共振胰胆管造影(MRCP)之后,揭示起源于胰腺的瘘管通路。患者通过内窥镜逆行胰胆管造影术(ERCP)接受保守治疗和内窥镜治疗,并将假体放置在瘘管路径上。他没有并发症就出院了,随着胸腔积液和瘘管的消退。这种情况的兴趣在于事件的罕见和可能的主要事件(急性胰腺炎)的症状的缺乏。与他常用药物的几种药物可能的医源性关联使其变得更加复杂。
Pancreaticopleural fistulas (PPF) are a rare etiology of pleural effusions. We describe a
case of a 61-year-old man, with left chest pain with six months of progression who presented with a large volume unilateral pleural effusion. A thoracentesis was performed, which showed a dark reddish fluid(exudate) and high content of pancreatic amylase. After that an abdominal computed tomography (CT)and magnetic resonance
cholangiopancreatography (MRCP) was done, revealing fistulous pathways that originated in the pancreas. The patient was admitted for conservative and endoscopic treatment by Endoscopic Retrograde
Cholangiopancreatography (ERCP) and a prosthesis was placed on a fistulous path. He was discharged without complications, with the resolution of the pleural effusion and fistula.The interest of this
case lies in the rarity of the event and absence of symptoms of the probable primary event (acute pancreatitis). The possible iatrogenic association with several drugs of his usual medication makes it even more complex.