Pancreaticoportal fistula: A rare complication of chronic pancreatitis

1990 ◽  
Vol 15 (1) ◽  
pp. 299-300 ◽  
Author(s):  
Werner Steenbergen ◽  
Eric Ponette
Keyword(s):  
Chronic Pancreatitis ◽  
Rare Complication

scholarly journals Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis

2021 ◽  
Author(s):  
Ayah Megahed ◽  
Rahul Hegde ◽  
Pranav Sharma ◽  
Rahmat Ali ◽  
Anas Bamashmos
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Pleural Fluid ◽  
Rare Complication ◽  
Delayed Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pleural Effusions ◽  
Diagnostic Challenge ◽  
Abdominal Symptoms ◽  
Pancreatic Duct Stenting

AbstractPancreaticopleural fistula is a rare complication of chronic pancreatitis caused by disruption of the pancreatic duct and fistulous communication with the pleural cavity. It usually presents with respiratory symptoms from recurrent large volume pleural effusions. Paucity of abdominal symptoms makes it a diagnostic challenge, leading often to delayed diagnosis. Marked elevation of pleural fluid amylase, which is not a commonly performed test, is a sensitive marker in its detection. Imaging with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography can help delineate the fistula. In this report, we present the clinical features, imaging, and management of a 59-year-old male patient with pancreaticopleural fistula, wherein the diagnosis was suspected only after repeated pleural fluid drainages were performed for re-accumulating pleural effusions and it was eventually successfully treated with pancreatic duct stenting. We review the literature with regards to the incidence, presentation, diagnosis, and management of this rare entity.

Pancreatico-Pleural Fistula Presenting as Recurrent Bilateral Pleural Effusion: A Rare Complication of Chronic Pancreatitis

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S803-S804
Author(s):  
Ranjit Makar ◽  
Muthena Maklad ◽  
Mohamad Mubder ◽  
Joseph M. Fayad ◽  
Bipin Saud
Keyword(s):  
Chronic Pancreatitis ◽  
Pleural Effusion ◽  
Rare Complication ◽  
Bilateral Pleural Effusion

scholarly journals Gastrointestinal Hemorrhage Due to Splenic Artery Aneurysm Pancreatic Duct Fistula in Chronic Pancreatitis

HPB Surgery ◽  
1993 ◽  
Vol 7 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Christian Seiler ◽  
Leslie H. Blumgart
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Gastrointestinal Hemorrhage ◽  
Splenic Artery ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Life Threatening ◽  
Threatening Situation

Gastrointestinal hemorrhage due to splenic artery aneurysm pancreatic duct fistula in chronic pancreatitis is rare. It is, however, important to diagnose this condition particularly in patients having chronic pancreatitis, since it may result in a life-threatening situation. The diagnosis is usually difficult to establish and it may take repeated admissions for intermittent gastrointestinal bleeding until the real source is recognized. Clinical attacks of epigastric pain followed by GI-bleeding 30–40 minutes later are characteristic. Occasionally these attacks are followed by transient jaundice. The present case report describes this rare complication and reviews the current literature.

Abstract 17237: A Pair Of Diaphragm-Crossed Organs: A Pancreatico-Pericardial Fistula

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Mary Pelling ◽  
Lena Chu ◽  
Krishan J Patel ◽  
Amalia Aldredge ◽  
Matthew T Brown
Keyword(s):  
Chronic Pancreatitis ◽  
Pericardial Effusion ◽  
Percutaneous Drainage ◽  
Rare Complication ◽  
Endoscopic Stenting ◽  
Successful Resolution ◽  
History Of ◽  
Pancreatic Fistulas ◽  
High Concentrations ◽  
Immunodeficiency Syndrome

Introduction: Pseudocysts are a known complication of chronic pancreatitis, occurring in 30-40% of patients. They form when disruption of the pancreatic duct system creates fluid-filled pockets with high concentrations of digestive enzymes. Leakage of these enzymes can create pancreatic fistulas. Here, we present a case of an unusual fistula that occurred in an immunocompromised individual. Case Description: A 34-year-old man with a history of Acquired Immunodeficiency Syndrome, alcohol use disorder, and chronic pancreatitis who had recently recovered from acute pancreatitis complicated by pericardial effusion was readmitted with worsening pleuritic chest pain and shortness of breath. He was hemodynamically stable with a normal cardiopulmonary exam without jugular venous distention or pulsus paradoxus. Labs were at his baseline other than an elevated d-dimer level. Computed tomography scan revealed a large, loculated pericardial effusion with a fistula extending through the diaphragm to a large peripancreatic pseudocyst. Gastroenterology performed pancreatic ductal stenting via endoscopic retrograde cholangiopancreatography and Interventional Radiology placed a percutaneous drainage catheter to facilitate resolution of the pseudocyst. Discussion: A pancreatico-pericardial fistula is a very rare complication of chronic pancreatitis. A 2016 review detailed only fifteen cases over a 40-year span with surgical management providing the best outcomes. Given this patient’s immunocompromise and malnutrition surgery was not offered, but endoscopic stenting and percutaneous drainage allowed for successful resolution of his fistula.

3026 Rare Complication of Chronic Pancreatitis: Chronic Portal Vein Thrombus Causing Pre-Hepatic Portal Hypertension

2019 ◽  
Vol 114 (1) ◽  
pp. S1635-S1635
Author(s):  
Ahmed Elbanna ◽  
Shyamraj Aishwarya ◽  
Al-Shammari Mustafa ◽  
Andrew Watson ◽  
Robert Pompa ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Rare Complication ◽  
Portal Vein Thrombus ◽  
Hepatic Portal

scholarly journals Spontaneous pancreatic pseudocyst – superior mesenteric vein fistula: A rare complication of chronic pancreatitis

2020 ◽  
Vol 15 (10) ◽  
pp. 1939-1942
Author(s):  
Hanna Tomsan ◽  
Cristina Olivas-Chacon ◽  
Mohammad Reza Hayeri ◽  
Aparna Srinivasa Babu
Keyword(s):  
Chronic Pancreatitis ◽  
Superior Mesenteric Vein ◽  
Pancreatic Pseudocyst ◽  
Rare Complication ◽  
Mesenteric Vein

scholarly journals Endovascular treatment of pseudoaneurysms secondary to chronic pancreatitis: reports of two cases

2018 ◽  
Vol 17 (1) ◽  
pp. 71-75
Author(s):  
Fabiana Seifert Santos ◽  
Karolaine Marcelina da Silva Sousa ◽  
Thiago Augusto Cadorin de Castro ◽  
Felipe Coelho Neto ◽  
Rodrigo Gomes de Oliveira ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Acute Hemorrhage ◽  
Gold Standard Method ◽  
Abdominal Bleeding ◽  
Thoracic And Abdominal

Abstract Pseudoaneurysm secondary to chronic pancreatitis is a rare complication, but one with a high mortality rate. It is etiologically associated with chronic pancreatitis, and most diagnoses are made after rupture, which manifests with clinical signs of acute hemorrhage. Computed tomography plays an important role in diagnosis, but digital subtraction angiography remains the gold-standard method for diagnostic confirmation and for treatment planning. This article describes two cases of pseudoaneurysm in patients with chronic alcoholic pancreatitis; one involving the splenic artery and the other the gastroduodenal artery, complicated by thoracic and abdominal bleeding respectively. Both were successfully treated, using minimally invasive endovascular methods to implant coils and stent-grafts.

Sump syndrome – A rare complication of surgery of chronic pancreatitis

Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S103
Author(s):  
Tamas Marjai ◽  
Balazs Tihanyi ◽  
Laszlo Harsanyi ◽  
Tibor Tihanyi ◽  
Laszlo Nehez
Keyword(s):  
Chronic Pancreatitis ◽  
Rare Complication ◽  
Complication Of Surgery

Intrapancreatic guidewire outer coat stripping during endoscopic treatment of chronic pancreatitis: A rare complication

2017 ◽  
Vol 46 (2) ◽  
pp. 240-241
Author(s):  
Tarik Adioui ◽  
Mouna Tamzaourte ◽  
Youssef Touibi ◽  
Fedoua Rouibaa ◽  
Aziz Aourarh
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Treatment ◽  
Rare Complication ◽  
Outer Coat

scholarly journals Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teera Kijmassuwan ◽  
Prapun Aanpreung ◽  
Varayu Prachayakul ◽  
Prakarn Tovichien
Keyword(s):  
Chronic Pancreatitis ◽  
Pleural Effusion ◽  
Pancreatic Duct ◽  
Imaging Modality ◽  
Rare Complication ◽  
Clinical Suspicion ◽  
High Index ◽  
Fistula Tract ◽  
Radiological Imaging ◽  
Pancreatic Duct Stent

Abstract Background Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis (CP) that requires a high index of clinical suspicion in the patient who presents with a pleural effusion. Visualizing the fistula tract from the pancreatic duct to the pleural space by radiological imaging provides confirmation of this complication. Case presentation A 9-year-old boy who presented with massive right pleural effusion secondary to PPF, a complication of CP from a genetic mutation involving two mutations of SPINK1. We successfully managed the case with by endoscopic pancreatic duct stent placement after failure of conservative treatment approaches. Conclusions PPF is a rare but serious complication of CP in all ages. The diagnosis of PPF in children requires a high index of clinical suspicion and should be considered in the differential diagnosis of massive pleural effusion where pancreatic pathology is present. A high level of pleural fluid amylase and the results from radiological imaging when the patients have symptoms play essential roles in the diagnosis of PPF. Currently, Magnetic resonance cholangiopancreatigraphy (MRCP) is the imaging modality of choice. Endoscopic therapy and surgery are treatment options for patients who do not respond to conservative therapy.

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