DSpace university logo mark
Advanced Search
Japanese | English 

NAOSITE : Nagasaki University's Academic Output SITE > School of Medicine > Bulletin > Acta Medica Nagasakiensia > Volume 48, No. 1-2 >

A Case of Pancreatic Ascites and Pleural Effusion: Confirmation of a Pancreatic Duct Contrast Leakage Using Computed Tomography after Endoscopic Retrograde Cholangiopancreatography


File Description SizeFormat
acta48_01_14_t.pdf1.32 MBAdobe PDFView/Open

Title: A Case of Pancreatic Ascites and Pleural Effusion: Confirmation of a Pancreatic Duct Contrast Leakage Using Computed Tomography after Endoscopic Retrograde Cholangiopancreatography
Authors: Matsumoto, Kojiro / Tanigawa, Ken / Nakao, Hideto / Okudaira, Sadayuki / Yamada, Masashi / Eguchi, Katsumi
Issue Date: 25-Jun-2003
Citation: Acta medica Nagasakiensia. 2003, 48(1-2), p.73-76
Abstract: A seventy-two year old Japanese man with chronic alcoholism was admitted with increasing epigastric pain and abdominal fullness. He gave a history of bouts of epigastric pain radiating to the back for the past year. At admission, abdominal ultrasonography and computed tomography (CT) demonstrated massive ascites and a pseudocyst in the pancreatic body. A chest X-ray showed bilateral pleural effusion, and the level of amylase was elevated in the serum, urine, ascitic fluid and pleural effusion. First, the patient was treated with nothing by mouth but with intravenous hyperalimentation, however, no improvement was noted after 2 weeks. Then, the patient underwent endoscopic retrograde cholangiopancreatography (ERCP) and abdominal CT after ERCP. They showed irregular dilatation of the pancreatic main duct and branch, and an extravasation of contrast media from the pancreatic duct into the peritoneal cavity, after which the patient underwent surgery. Because no fistula was found during surgery, drainages were retained into the pseudocyst and peritoneal cavity. Due to marked elevation of amylase and protein levels in ascitic fluid and pleural effusion and findings from ERCP and CT after ERCP, pancreatic ascites and pleural effusion was diagnosed. The diagnosis of chronic pancreatitis is due to his history, laboratory data, and irregular dilatation of the pancreatic duct on ERCP. After surgery, his clinical status improved rapidly. We thus described a case of pancreaticoperitoneal fistula demonstrated by CT scan subsequent to ERCP which was treated successfully by surgery.
Keywords: pancreatic pleural effusion / pancreatic ascites
URI: http://hdl.handle.net/10069/16247
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 48, No. 1-2

Citable URI : http://hdl.handle.net/10069/16247

All items in NAOSITE are protected by copyright, with all rights reserved.

 

Valid XHTML 1.0! Copyright © 2006-2015 Nagasaki University Library - Feedback Powerd by DSpace