Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
권호 표지
DOI QR코드

DOI QR Code

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula

식도 누공으로 자연 배액된 종격동 췌장성 가성낭종

  • Park, Soo Ho (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Park, Seung Keun (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kim, Sang Hyun (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Choi, Won Kyu (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Shim, Beom Jin (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Park, Hee Ug (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Jung, Chan Woo (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Choi, Jae Won (Division of Gastrology, Department of Internal Medicine, Maryknoll Medical Center)
  • 박수호 (부산 메리놀병원 소화기내과) ;
  • 박승근 (부산 메리놀병원 소화기내과) ;
  • 김상현 (부산 메리놀병원 소화기내과) ;
  • 최원규 (부산 메리놀병원 소화기내과) ;
  • 심범진 (부산 메리놀병원 소화기내과) ;
  • 박희욱 (부산 메리놀병원 소화기내과) ;
  • 정찬우 (부산 메리놀병원 소화기내과) ;
  • 최재원 (부산 메리놀병원 소화기내과)
  • Received : 2016.06.20
  • Accepted : 2016.08.29
  • Published : 2017.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

Keywords

References

  1. Roucaud N, Laine L, Marceau C, Montesino L, Paulet R, Coudray JM, et al. Mediastinal abscess with pericarditis: an unusual complication of severe pancreatitis. Am Surg 2010;76:1315-6.
  2. Metaxa D, Balakrishnan A, Upponi S, Huguet EL, Praseedom RK. Surgical intervention for mediastinal pancreatic pseudocysts. A case series and review of the literature. JOP 2015;16:74-7.
  3. Landreneau RJ, Johnson JA, Keenan RJ, Thompson WM, Megison S, Ferson PF. "Spontaneous" mediastinal pancreatic pseudocyst fistulization to the esophagus. Ann Thorac Surg 1994;57:208-10. https://doi.org/10.1016/0003-4975(94)90398-0
  4. Kwon NY, Kim DH, Hong SK, Choi EK, Park JS, Jee YK, et al. A case of mediastinal pancreatic pseudocyst. Tuberc Respir Dis 2001;51:482-7. Korean. https://doi.org/10.4046/trd.2001.51.5.482
  5. Belagyi T, Issekutz A, Paukovics A, Kecsks G, Olah A. Successful treatment of mediastinal pancreatic pseudocyst by pancreatic head resection. JOP 2008;9:346-9.
  6. Khan MS, Shahbaz N, Zia HA, Hamza M, Iqbal H, Awab A. Pancreaticopericardial fistula: a case report and literature review. Case Rep Crit Care 2016;2016:7169341.
  7. Ajmera AV, Judge TA. Mediastinal extension of pancreatic pseudocyst--a case with review of topic and management guidelines. Am J Ther 2012;19:e152-6. https://doi.org/10.1097/MJT.0b013e3181f62947
  8. Nasa M, Choudhary M, Patil G, Puri R. Mediastinal pancreatic pseudocyst. J Dig Endosc 2016:7:20-3. https://doi.org/10.4103/0976-5042.180095
  9. Geier A, Lammert F, Gartung C, Nguyen HN, Wildberger JE, Matern S. Magnetic resonance imaging and magnetic resonance cholangiopancreaticography for diagnosis and pre-interventional evaluation of a fluid thoracic mass. Eur J Gastroenterol Hepatol 2003;15:429-31. https://doi.org/10.1097/00042737-200304000-00016
  10. Kim HJ, Kim MH, Park DH, Kwon HM, Park SJ, Choi EJ, et al. Endoscopic ultrasound-guided transesophageal drainage of a mediastinal pancreatic pseudocyst. Korean J Pancreas Biliary Tract 2014;19:137-41. Korean. https://doi.org/10.15279/kpba.2014.19.3.137
  11. Lim YS, Kim AN, Kim SY, Lim SH, Kim NY, Lee KH, et al. A case of mediastinal abscess following esophageal perforation. Korean J Gastrointest Endosc 1992;12:9-12. Korean.
  12. Park SH, Kim SJ, Kim EJ, Lee MH, Kim HS, Chung IK, et al. A case of mediastinal pacreatic pseudocyst treated with octreotide. Korean J Gastroenterol 1999;34:417-21. Korean.
  13. Bardia A, Stoikes N, Wilkinson NW. Mediastinal pancreatic pseudocyst with acute airway obstruction. J Gastrointest Surg 2006;10:146-50. https://doi.org/10.1016/j.gassur.2005.05.009
  14. Lillemoe KD, Jarnagin WR. Hepatobiliary and pancreatic surgery. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.
  15. Panackel C, Korah AT, Krishnadas D, Vinayakumar KR. Pancreatic pseudocyst presenting as dysphagia: a case report. Saudi J Gastroenterol 2008;14:28-30. https://doi.org/10.4103/1319-3767.37801