Mediastinal Pancreatic Pseudocysts
Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concen...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2017-01-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2016-089.pdf |
| _version_ | 1797669335018242048 |
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| author | Krzysztof Dąbkowski Andrzej Białek Maciej Kukla Janusz Wójcik Andrzej Smereczyński Katarzyna Kołaczyk Tomasz Grodzki Teresa Starzyńska |
| author_facet | Krzysztof Dąbkowski Andrzej Białek Maciej Kukla Janusz Wójcik Andrzej Smereczyński Katarzyna Kołaczyk Tomasz Grodzki Teresa Starzyńska |
| author_sort | Krzysztof Dąbkowski |
| collection | DOAJ |
| description | Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity. A pancreatic stent was placed. The second day after the ERCP, the patient developed septic shock and was admitted to the intensive care unit. Computed tomography (CT) revealed mediastinal pseudocysts and bilateral pleural effusions. After bilateral drainage of the pleural cavities, the patient improved clinically, and a follow-up CT scan showed that the fluid collection and pseudocysts had resolved. We discuss the optimal strategies for diagnosing and treating patients with pancreatic thoracic pseudocysts and fistulas, as well as review the management of these conditions. |
| first_indexed | 2024-03-11T20:42:46Z |
| format | Article |
| id | doaj.art-bf7a3ff742a748bfb099a121b4d58c74 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:42:46Z |
| publishDate | 2017-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-bf7a3ff742a748bfb099a121b4d58c742023-10-02T01:07:34ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432017-01-01501768010.5946/ce.2016.0896910Mediastinal Pancreatic PseudocystsKrzysztof Dąbkowski0Andrzej Białek1Maciej Kukla2Janusz Wójcik3Andrzej Smereczyński4Katarzyna Kołaczyk5Tomasz Grodzki6Teresa Starzyńska7 Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland Department of Thoracic Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland Department of Radiology, Pomeranian Medical University, Szczecin, Poland Department of Thoracic Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland Department of Gastroenterology, Pomeranian Medical University, Szczecin, PolandMediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity. A pancreatic stent was placed. The second day after the ERCP, the patient developed septic shock and was admitted to the intensive care unit. Computed tomography (CT) revealed mediastinal pseudocysts and bilateral pleural effusions. After bilateral drainage of the pleural cavities, the patient improved clinically, and a follow-up CT scan showed that the fluid collection and pseudocysts had resolved. We discuss the optimal strategies for diagnosing and treating patients with pancreatic thoracic pseudocysts and fistulas, as well as review the management of these conditions.http://www.e-ce.org/upload/pdf/ce-2016-089.pdfAcute pancreatitisCholangiopancreatography, endoscopic retrogradeMediastinal pseudocysts |
| spellingShingle | Krzysztof Dąbkowski Andrzej Białek Maciej Kukla Janusz Wójcik Andrzej Smereczyński Katarzyna Kołaczyk Tomasz Grodzki Teresa Starzyńska Mediastinal Pancreatic Pseudocysts Clinical Endoscopy Acute pancreatitis Cholangiopancreatography, endoscopic retrograde Mediastinal pseudocysts |
| title | Mediastinal Pancreatic Pseudocysts |
| title_full | Mediastinal Pancreatic Pseudocysts |
| title_fullStr | Mediastinal Pancreatic Pseudocysts |
| title_full_unstemmed | Mediastinal Pancreatic Pseudocysts |
| title_short | Mediastinal Pancreatic Pseudocysts |
| title_sort | mediastinal pancreatic pseudocysts |
| topic | Acute pancreatitis Cholangiopancreatography, endoscopic retrograde Mediastinal pseudocysts |
| url | http://www.e-ce.org/upload/pdf/ce-2016-089.pdf |
| work_keys_str_mv | AT krzysztofdabkowski mediastinalpancreaticpseudocysts AT andrzejbiałek mediastinalpancreaticpseudocysts AT maciejkukla mediastinalpancreaticpseudocysts AT januszwojcik mediastinalpancreaticpseudocysts AT andrzejsmereczynski mediastinalpancreaticpseudocysts AT katarzynakołaczyk mediastinalpancreaticpseudocysts AT tomaszgrodzki mediastinalpancreaticpseudocysts AT teresastarzynska mediastinalpancreaticpseudocysts |