The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Pancreaticopleural Fistula Treated by Endoscopic Pancreatic Stenting in a Patient with Recurrent Pancreatitis

내시경 췌관 스텐트 삽입술로 치료된 췌관-흉막루

  • Kwon, Hyemi (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jihyang (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Eunji (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyojung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Jun Hyuk (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Byun, Jae Ho (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 권혜미 (울산대학교 의과대학 서울아산병원 내과) ;
  • 이지향 (울산대학교 의과대학 서울아산병원 내과) ;
  • 최은지 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김효정 (울산대학교 의과대학 서울아산병원 내과) ;
  • 최준혁 (울산대학교 의과대학 서울아산병원 내과) ;
  • 변재호 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 김명환 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2014.03.10
  • Accepted : 2014.05.15
  • Published : 2014.10.01
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Abstract

Pancreatic duct disruption associated with pancreatitis can lead to the development of pseudocysts, pancreatic ascites, and pleural effusion. A 50-year-old male presented with a 1-month history of postprandial epigastric pain. A chest X-ray showed right pleural effusion. Diagnostic thoracentesis revealed an amylase-rich exudate consistent with pancreatic effusion. Magnetic resonance cholangiopancreatography demonstrated a pancreaticopleural fistula tract, and endoscopic retrograde pancreatography confirmed the presence of pancreatic ductal disruption and leakage at the genu portion. The pancreaticopleural fistula was treated by transpapillary pancreatic stenting. Percutaneous drainage of the pleural effusion and octreotide injection were also performed. Follow-up endoscopic retrograde pancreatography at 8 weeks revealed no leakage of contrast media from the main pancreatic duct. Endoscopic pancreatic stenting can be an efficacious nonsurgical treatment of pancreaticopleural fistula following pancreatitis.

췌관-흉막루는 췌관 파열 혹은 교통성 가성 낭종을 통하여 췌액이 흉강에 도달하는 상태이다. 췌장염 환자에서 췌관-흉막루로 인한 흉수는 드문 합병증으로, 이번 증례는 자기공명영상 담췌관조영술 소견으로 췌장염과 동반된 췌관-흉막루를 진단할 수 있었고, 내시경 역행성 췌관 조영술로 이를 확인하고 췌관 내에 스텐트를 삽입하여 췌관-흉막루를 효과적으로 치료한 증례이다.

Keywords

References

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