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  • Title: Surgical treatment for right pleural effusions caused by pancreaticopleural fistula.
    Author: Shibasaki S, Yamaguchi H, Nanashima A, Tsuji T, Jibiki M, Sawai T, Yasutake T, Nakagoe T, Ayabe H.
    Journal: Hepatogastroenterology; 2003; 50(53):1678-80. PubMed ID: 14571815.
    Abstract:
    A 56-year-old man with a history of alcohol abuse presented with exertional dyspnea. A chest radiography showed a massive right pleural effusion with sanguineous pleural fluid and an amylase level of 97,188 IU/L. Despite conservative treatment with no oral intake, total parenteral nutrition and repeated thoracentesis, the pleural effusion was persistent and intrathoracic infection was suspected. Surgical intervention was proposed and a preoperative endoscopic retrograde cholangiopancreatography revealed disruption of the mid pancreatic duct and a fistulous tract. A middle segment pancreatectomy was performed for removal of the disrupted portion of the main pancreatic duct and reconstruction of the distal pancreas was completed by end-to-side Rouxen-Y pancreatojejunostomy. The patient had a good postoperative course and was discharged on the 29th postoperative day. He has remained well during the 9 months of follow-up.
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