Pancreatic acinar cell carcinoma developed in the pancreatic head after distal pancreatectomyfor chronicpancreatitis
Pancreatology(2016)
Abstract
La fístula pancreaticopleral es una rara complicación de la pancreatitis aguda o crónica, que requiere de tratamiento médico (análogos de somatostatina), endoscópico o quirúrgico para su resolución, siendo el primero de estos de elección. Presentamos el caso de un varón de 64 años que presenta disrupción completa del conducto de Wirsung, diagnosticada mediante ecoendoscopia y complicada con colección subfrénica, perforación diafragmática y posterior empiema. En este caso se ensayó sin éxito tratamiento médico y posteriormente endoscópico, que permitió finalmente la resolución de la lesión anatómica. El paciente precisó además una intervención quirúrgica para conseguir la evacuación de la colección pleural.Pancreaticopleural fistula is a rare complication of acute or chronic pancreatitis, requiring medical (somatostatin), endoscopic or surgical treatment, with medical treatment being the first option. We describe the case of a 64-year-old man who showed complete disruption of Wirsung's duct that was diagnosed through ultrasound endoscopy and was complicated by the development of a subphrenic collection, diaphragm perforation and subsequent empyema. Medical therapy was attempted without success, and anatomical restoration of the duct was achieved after endoscopic treatment. The patient also required surgery to evacuate the pleural collection.
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Key words
pancreatic acinar cell carcinoma,pancreatic head,chronicpancreatitis
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