Two cases of thoracopancreatic fistula in alcoholic pancreatitis: Clinical and CT findings

Hisao Ito, Nobumichi Matsubara, Toshihiko Sakai, Noboru Aso, Masahiro Kitami, Schu ichi Ono, Tadashi Ishibashi

研究成果: Article査読

15 被引用数 (Scopus)

抄録

We report two patients who were long-time habitual consumers of alcohol and suffered from thoracopancreatic fistula. The first patient, a 52-year-old man with no symptoms, underwent chest CT scan for a medical check-up and was revealed to have left small pleural effusion. A month later, he suddenly experienced severe cough and back pain. The immediate CT scan showed massive pleural effusion and mediastinal pseudocyst, and the amylase level in the aspirated pleural effusion proved to be elevated. He was successfully treated with medication and drainage of the effusion. The second patient, a 39-year-old woman, underwent CT scan for a medical check-up, and it disclosed that she had a small pleural effusion in the left lower thorax. Follow-up CT two months later revealed the pleural effusion to be resolved, however, it demonstrated that a narrow tract derived from the pancreatic secretion located just posterior to the pancreatic tail extended to the mediastinum along the left hemidiaphragmatic crus. She experienced severe cough and sputum four months later. CT scan showed massive pleural effusion in the left thorax and revealed that the pancreaticopleural fistula was located in the same position as the small tract that had been detected by the previous CT scan. The patient received conservative treatment and eventually recovered from the severe chest complications. We consider that asymptomatic left small pleural effusion in these patients who were habitual drinkers is a potential precursor to symptomatic pancreatitis. The patients developed mediastinal pseudocyst and pancreaticopleural fistula in association with chronic pancreatitis within a few months, and therefore intensive follow-up should be undertaken to minimize or prevent chest complications in association with the subsequent symptomatic pancreatitis.

本文言語English
ページ(範囲)207-211
ページ数5
ジャーナルRadiation Medicine - Medical Imaging and Radiation Oncology
20
4
出版ステータスPublished - 2002 7
外部発表はい

ASJC Scopus subject areas

  • 放射線
  • 放射線学、核医学およびイメージング
  • 腫瘍学

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