Pancreaticopleural fistula

Revisited

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.

Original languageEnglish
Article number815476
JournalDiagnostic and Therapeutic Endoscopy
DOIs
Publication statusPublished - 2012

Fingerprint

Pleural Effusion
Fistula
Pleural Cavity
Octreotide
Endoscopic Retrograde Cholangiopancreatography
Pancreatic Ducts
Chronic Pancreatitis
Amylases
Pancreatitis
Pancreas
Magnetic Resonance Spectroscopy
Thorax
Communication
Alcohols
Therapeutics
Conservative Treatment

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Pancreaticopleural fistula : Revisited. / MacHado, Norman Oneil.

In: Diagnostic and Therapeutic Endoscopy, 2012.

Research output: Contribution to journalReview article

@article{30d6653fd19b472d9666bdc500a23867,
title = "Pancreaticopleural fistula: Revisited",
abstract = "Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.",
author = "MacHado, {Norman Oneil}",
year = "2012",
doi = "10.1155/2012/815476",
language = "English",
journal = "Diagnostic and Therapeutic Endoscopy",
issn = "1070-3608",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Pancreaticopleural fistula

T2 - Revisited

AU - MacHado, Norman Oneil

PY - 2012

Y1 - 2012

N2 - Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.

AB - Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.

UR - http://www.scopus.com/inward/record.url?scp=84858251422&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84858251422&partnerID=8YFLogxK

U2 - 10.1155/2012/815476

DO - 10.1155/2012/815476

M3 - Review article

JO - Diagnostic and Therapeutic Endoscopy

JF - Diagnostic and Therapeutic Endoscopy

SN - 1070-3608

M1 - 815476

ER -