背景:黑色胸腔积液是一种罕见的医学病症和诊断标志物。胰腺胸膜瘘是黑色胸腔积液的原因之一。到目前为止,由胰胸膜瘘引起的黑色胸腔积液主要在酒精诱发的慢性胰腺炎患者中报道。在这份报告中,我们介绍了一例由自身免疫性胰腺炎相关的胰腺胸膜瘘引起的黑色胸腔积液。
方法:一名59岁女性,无饮酒史,主诉呼吸困难,来我院就诊,以及胸部和背部的不适。她留下了胸腔积液,胸腔穿刺术显示黑色胸腔积液。计算机断层扫描显示存在从胰尾到左胸膜腔的包封液,被诊断为胰腺胸膜瘘。它还显示弥漫性胰腺肿胀。血清测试显示高IgG4水平(363mg/dL)。这些发现导致了自身免疫性胰腺炎的诊断。
结果:患者接受内镜下胰腺括约肌切开术和胰管支架置入术,并接受类固醇治疗。治疗后,没有观察到胸腔积液的进一步积聚。
结论:这是首次报道与自身免疫性胰腺炎相关的胰腺胸膜瘘引起的黑色胸腔积液。黑色胸腔积液的特征性外观可能有助于诊断。我们报告此病例以强调自身免疫性胰腺炎可能是黑色胸腔积液的原因。
BACKGROUND: Black pleural effusion is a rare medical condition and a diagnostic marker. Pancreaticopleural fistula is one of the causes of black pleural effusion. Thus far, black pleural effusions caused by pancreaticopleural fistulae have mostly been reported in patients with alcohol-induced chronic pancreatitis. In this report, we present a
case of black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis.
METHODS: A 59-year-old female without a history of alcohol drinking presented to our hospital with a chief complaint of dyspnea, as well as chest and back discomfort. She had left pleural effusion, and thoracentesis showed black pleural effusion. Computed tomography revealed the presence of encapsulated fluid from the pancreatic tail to the left pleural cavity, which was diagnosed as a pancreaticopleural fistula. It also showed diffuse pancreatic swelling. Serum testing showed a high IgG4 level (363 mg/dL). These findings led to the diagnosis of autoimmune pancreatitis.
RESULTS: The patient underwent endoscopic pancreatic sphincterotomy and pancreatic duct stent placement and received treatment with steroids. After treatment, there was no further accumulation of pleural effusion observed.
CONCLUSIONS: This is the first report of black pleural effusion due to a pancreaticopleural fistula associated with autoimmune pancreatitis. The characteristic appearance of black pleural effusion may assist diagnosis. We report this
case to emphasize that autoimmune pancreatitis can be a cause of black pleural effusion.