Slovenská chirurgia 4/2014

Surgical treatment of pancreatico-pleural fistula on patient with chronic pancreatitis – case report

Pancreatico-pleural fistula (PPF) is rare complication of acute and chronic pancreatitis. PPF is manifested more frequently with pulmonary symptoms than abdominal. Most patients have a left pleural effusion, rarely are described cases of bilateral or right-sided effusion. Early screening of amylase values in pleural punctate can significantly contribute to the diagnosis. Conservative treatment with chest drainage and octreotide application is the method of choice. In case of failure of conservative treatment other therapeutic modalities are ERCP stenting of pancreatic duct and surgical treatment. The authors present a case of 44 year old patient with undergone severe form of acute pancreatitis with CT and MRCP confirmed pancreatico-pleural fistula. The excision of the fistula was performed and pancreaticojejunoanastomosis sec. Ω and jejunojejunoanastomosis was sewn.

Keywords: pancreatico-pleural fistula, chronic pancreatitis, surgical treatment.