Pancreaticopleural fistula: an uncommon cause of amylase-rich pleural effusion

2020 ◽  
Vol 13 (8) ◽  
pp. e236232
Author(s):  
Valeri Kraskovsky ◽  
Brianne Mackenzie ◽  
Martin Jeffery Mador
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Pancreatitis ◽  
Pleural Effusion ◽  
Pancreatic Duct ◽  
Chronic Obstructive ◽  
Endoscopic Retrograde ◽  
Obstructive Pulmonary Disease ◽  
Rare Finding ◽  
Fluid Analysis ◽  
Exudative Pleural Effusion

Pancreaticopleural fistula (PPF) causing pleural effusion as a complication of chronic pancreatitis is a rare finding. We present this finding in a 52-year-old man with a medical history significant for alcohol abuse, acute on chronic pancreatitis and severe chronic obstructive pulmonary disease, who presented with worsening dyspnoea for 3 days. CT scan of the chest showed a new large right-sided pleural effusion. Thoracentesis was performed and pleural fluid analysis showed an amylase-rich, exudative pleural effusion. The effusion reaccumulated within 3 days necessitating repeat thoracentesis. Endoscopic retrograde chloangiopancreatography showed contrast leak through a single disruption in the dorsal pancreatic duct, suspicious for an underlying PPF. The patient underwent stenting of the pancreatic duct with subsequent resolution of right-sided pleural effusion.

Exudative pleural effusion due to brucellosis in a patient with chronic obstructive pulmonary disease

2006 ◽  
Vol 36 (4) ◽  
pp. 253-254 ◽  
Author(s):  
Ayhan Zengi ◽  
Funda Elmas ◽  
Meltem Tasbakan ◽  
Ozen Kacmaz Basoglu ◽  
Mustafa Hikmet Ozhan
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pleural Effusion ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Exudative Pleural Effusion

Comparison of plasmapheresis efficacy and complex antioxidant therapy in patients with comorbid course of chronic pancreatitis and chronic obstructive pulmonary disease

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
O. S. Khukhlina ◽  
O. O. Ursul ◽  
V. S. Smandych
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Pancreatitis ◽  
Pulmonary Disease ◽  
Underlying Disease ◽  
Pancreatic Tissue ◽  
Inhalation Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Complex Therapy ◽  
Reduced Intensity

60 patients with chronic obstructive pulmonary disease (COPD) and chronic pancreatitis (CP) were examined in the dynamics of treatment. The complex therapy of patients with COPD and CP including inhalation therapy with Thiotropium bromide, Serrathiopeptidase and Emoxypin promoted reduced intensity of oxidative stress, restoration of antioxidant protective components activity and natural detoxication system, intensified the activity of enzymatic, Hagemmandependant fibrinolysis and collagenosis, improving the processes of microcirculation, elimination of ischemia and swelling of the pancreatic tissue, quick removal of clinical exacerbation signs of the underlying disease and comorbid diseases. According to the correction degree of enzyme deviation syndrome in the blood, intensity of nitrositic stress and endogenic intoxication in patients with COPD and CP, the effect of 30-day intake of Serrathiopeptidase and 15-day intake of Emoxypin is equal to the efficacy of five plasmapheresis sessions.

scholarly journals Smoking as a factor of immune deficiency deepening in patients with chronic obstructive pulmonary disease and chronic pancreatitis

2019 ◽  
pp. 17-22
Author(s):  
L. S. Babinets ◽  
R. G. Protsyuk ◽  
O. S. Kvasnitska
Keyword(s):  
Immune Deficiency ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Pancreatitis ◽  
Immune System ◽  
Inflammatory Process ◽  
Clinical Laboratory ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cellular Immune System ◽  
Cellular Immune

The objective of the work – to study the state of humoral link of the immune system in patients with chronic pancreatitis with concomitant COPD and without it. There were examined 90 patients with COPD in combination with chronic pancreatitis (45 women and 45 men) aged 35–86 years, mean age – (56.42 ± 4.11 years) and 43 – with chronic pancreatitis. Among the examined individuals there were 32 persons with chronic pancreatitis and COPD I st. (35.5 %), and 58 persons with chronic pancreatitis and COPD II st. (64.5 %). Duration of the disease – from 1 to 25 years, the combination of diseases – from 1 to 10 years. There were 20 (22.2 %) active smokers among surveyed patients. The duration of the smoking 10–30 years, middle duration – (22.75 ± 1.20) years. The smoking experience of 9 patients was 10–20 packs/years, 11 – more than 20 pack/years. Methods of examination: general clinical, laboratory, instrumental, questioning, testing, statistical methods. In patients with chronic pancreatitis without COPD, the level of all studied classes of Ig was significantly increased (IgG 10.4 %, IgA 13.1 %, IgM 45.9 %; P < 0.05). Disbalance in immunoglobulines level was detected in patients with COPD with a significant decrease (P < 0.05) in IgG and IgA levels (by 7.9 % and 27.3 % respectively) and IgM increased (by 76.7 %). This indicates an imbalance in the functioning of the cellular immune system with the formation of a secondary immune deficiency. The increase in the level of immune complexes in both groups (2.6 and 3.2 times, respectively) showed the presence of torpid inflammatory process in COPD. The presence of tobacco smoking in patients with chronic pancreatitis and COPD significantly deepened the changes in the immune system in comparison with non-smokers.

scholarly journals Quality of life in patients with comorbidity of chronic pancreatitis and chronic obstructive pulmonary disease in presence of smoking

2019 ◽  
pp. 18-22
Author(s):  
L. S. Babinets ◽  
О. S. Kvasnitska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Pancreatitis ◽  
Pulmonary Disease ◽  
Physical Functioning ◽  
Clinical Course ◽  
Life Quality ◽  
Chronic Obstructive ◽  
General Health Status ◽  
Obstructive Pulmonary Disease

Background. A combination of chronic pancreatitis and chronic obstructive pulmonary disease is quite common in clinical practice. This has a negative effect on the clinical course of both diseases. Smoking increases risk of chronic pancreatitis development. Purpose of the study. The purpose of this investigation is to learn smoking influence on clinical course and life quality of patients with comorbidity of chronic pancreatitis and chronic obstructive pulmonary disease. Material and methods. 141 patients with chronic pancreatitis with chronic obstructive pulmonary disease and without it had been examinated. 98 patients with chronic pancreatitis with chronic obstructive pulmonary disease were included to the main group. Both diseases were at phase of remission. Results and discussion. 29 (20.6 %) active smokers were among them. All of them are men. The main syndromes in patients with chronic pancreatitis with chronic obstructive pulmonary disease are dyspeptic (85.7%) and astenic (94.9 %), pain syndrome was registered in 83.7 % patients, the equivalents of pain were observed in 16.3 % of patients. Conclusions. Significant decreasing of life quality in patients with comorbidity of chronic pancreatitis and chronic obstructive pulmonary disease was proved: scales of physical functioning, role physical functioning and general health status were significantly decreased in patients with concomitant COPD (р <0.05). Analysis of the GSRS questionnaire revealed a significant (p <0.05) increasing in three of the five scales presented in patients with chronic pancreatitis and COPD, indicating a deterioration of quality of life in case of comorbidity. There were revealed significant decreasing of physical functioning scale and general health status scale (questionnaire SF‑36) and increasing of all scales in GSRS scales (except for the diarrheal syndrome scale). Significant (p <0.05) moderate correlations were found between the scales of physical functioning and role physical functioning and smoking experience, and moderate correlations with the smoking experience of the dyspeptic syndrome score.

scholarly journals Pancreatico-pericardial fistula as a complication of chronic pancreatitis

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 31 ◽  
Author(s):  
Camille Anne Sommer ◽  
C. Mel Wilcox
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Poor Prognosis ◽  
Rare Complication ◽  
Pericardial Fluid ◽  
Endoscopic Retrograde ◽  
Fluid Analysis ◽  
Pancreatic Duct Stent ◽  
Pancreatic Duct Stenting ◽  
Duct Disruption

Pancreatico-pericardial fistula is an extremely rare complication of chronic pancreatitis. We present a case of a 58-year-old man who presented with syncope. Transthoracic echocardiogram revealed a pericardial effusion with tamponade physiology. Pericardiocentesis and pericardial fluid analysis demonstrated a lipase level of 2321 U/L. Subsequently, an endoscopic retrograde cholangiopancreatography (ERCP) was performed, confirming the presence of a pancreatico-pericardial fistula (PPF) from the distal body of the pancreas. A pancreatic duct stent was placed across the duct disruption on two separate occasions; however, despite stent placement, the patient continued to re-accumulate pericardial fluid and deteriorated. While rare, PPFs may complicate chronic pancreatitis, may not respond to pancreatic duct stenting and may portend a poor prognosis.

scholarly journals IMPACT OF SMOKING ON THE MAIN PATHOGENETIC LINKS OF COMORBID COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CHRONIC PANCREATITIS

2018 ◽  
pp. 103-108
Author(s):  
O. S. Khukhlina ◽  
O. O. Ursul ◽  
I.V. Dudka ◽  
K. V. Viligorska ◽  
L. V. Kaniovska ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Chronic Pancreatitis ◽  
Tobacco Smoking ◽  
Chloride Channel ◽  
Chronic Obstructive ◽  
Exocrine Glands ◽  
Obstructive Pulmonary Disease ◽  
Ions Transport ◽  
Chlorine Ions

In the result of the study examined 79 patients, among them 30 patients with isolated course of COPD, stage ІІВ, 22 patients with COPD, stage ІІВ with comorbid CP in exacerbation phase, 27 patients with isolated course of CP. Smoking impacts deprivation of CFTR function, which regulates chlorine ions transport through chorine channel, localized in the epithelial cells of exocrine glands. The inhibition of the functioning of the chloride channel leads to thickening of the exocrine glands secret that results in its poor evacuation and then obstruction with fibrosis in the organs, such as lungs, liver, gallbladder, pancreas. That why tobacco smoking may be a risk factor for development not only COPD, but also CP.

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