Presentation
Four patients presented with ascites, one patient presented with ascites and bilateral pleural effusion and the sixth patient presented with left-sided pleural effusion. [ncbi.nlm.nih.gov]
In 22 patients the fistula was into the peritoneal cavity and they presented with pancreatic ascites. In 7 patients the fistula tracked up through the mediastinum into a pleural cavity, and they presented with pancreatic pleural effusions. [doi.org]
Workup
Microbiology
- Eikenella
We present a case of a right perirenal Eikenella corrodens abscess in a patient with chronic pancreatitis and poor dental hygiene. [ncbi.nlm.nih.gov]
Treatment
In case of conservative treatment failure, operative treatment is indicated, but this has significantly higher percentage of morbidity and mortality. [ncbi.nlm.nih.gov]
This treatment is continued for 2–3 weeks, and the patient is observed for improvement. If no improvement is seen, the patient may receive endoscopic or surgical treatment. [en.wikipedia.org]
Prognosis
It is important to focus on WBC count from POD 1, which can be great help to distinguish the high-risk patients and to improve the prognosis after surgery. After PD and PPPD, patients with increases of WBC count are likely to develop grade B-C. [kjco.org]
Treatment approaches PJA disconnection and drainage procedures during surgical revision after PD in cases of PP are usually insufficient and do not lead to a better prognosis. [hbsn.amegroups.com]
Favourable prognosis after surgical drainage of gunshot, stab or blunt trauma of the pancreas. Br J Surg. 1995; 82 :1236–1239. [ PubMed ] [ Google Scholar ] 25. Dodds WJ, Taylor AJ, Erickson SJ, Lawson TL. [ncbi.nlm.nih.gov]
Etiology
Maintaining a high index of suspicion is essential for the etiologic diagnosis of pancreatic pleural fistula in children. [ncbi.nlm.nih.gov]
The results indicate a significant relationship between etiology of the fistula and treatment effect. [ingentaconnect.com]
Keith J Roberts, Maria Sheridan, Gareth Morris-Stiff and Andrew M Smith, Pancreaticopleural fistula: etiology, treatment and long-term follow-up, Hepatobiliary & Pancreatic Diseases International, 11, 2, (215), (2012). Richard A. [doi.org]
Epidemiology
* Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY † Center of Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY ‡ Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer [journals.lww.com]
Author Affiliations From the Division of Hepatopancreatobiliary Surgery (P.J.A., M.F.B., A.A.B., L.M.R., M.M.P., K.E.C., M.I.D., R.P.D., T.P.K., Y.F., W.R.J.), and the Department of Epidemiology and Biostatistics (M.G.), Memorial Sloan-Kettering Cancer [nejm.org]
Epidemiology of pancreatic cancer. World J Gastroenterol. 2016;22(44):9694-705. 90. Malvezzi M, Bertuccio P, Rosso T, Rota M, Levi F, La Vecchia C, et al. [scriptiebank.be]
EPIDEMIOLOGY POPF commonly occur following either PD or distal pancreatectomy (DP). Fistulae after PD The incidence ranges from 0-24% with an average fistula rate of 12.9% following PD [ 4 ]. [pancreas.imedpub.com]
Pathophysiology
"Ascites fluid in severe acute pancreatitis: from pathophysiology to therapy". Acta Gastroenterol Belg. 63 (3): 264–8. PMID 11189983. Iacono C, Procacci C, Frigo F, Andreis IA, Cesaro G, Caia S, Bassi C, Pederzoli P, Serio G, Dagradi A (1989). [en.wikipedia.org]
This largely relates to a poor understanding of the pathophysiology of this complication. POP is now emerging as a possible critical factor in the underlying pathophysiology of POPF. [dovepress.com]
Prevention
The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. [ncbi.nlm.nih.gov]
The prediction and prevention of POPF remains an area of debate with several questions yet to be firmly addressed with solid answers. [bora.uib.no]