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Abstract

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Article in Japanese

Diagnostic Imaging

Two cases of mediastinal pancreatic pseudocyst accompanied by pancreatic pleural effusion

Shun Ito  Yukiko Kawaguchi  Takayasu Ito  Tatsuya Takaki  Akira Fukushima  Masami Matsumoto 

Department of Pulmonary Medicine, Ichinomiya Municipal Hospital

ABSTRACT

We report two patients with pancreatic pleural effusion who presented with dyspnea. Patient 1 was a male in his 40s and patient 2 was a male in his 60s. Both have the same past history of chronic alcohol-related pancreatitis. The chest X-ray and CT images showed massive pleural effusion and a pancreatic pseudocyst extending to the posterior mediastinum through the esophageal hiatus. The thoracentesis fluid was bloody, black in color, and sterile. Amylase in pleural fluid was elevated to a high level. From these examinations, in both cases a diagnosis of chronic alcohol-related pancreatitis accompanied by mediastinal pancreatic pseudocyst and pancreatic pleural effusion was made. Patient 1 was treated by thoracic cavity drainage, endoscopic nasopancreatic drainage, and somatostatin analogue. Patient 2 underwent only thoracic cavity drainage. In both cases, the pleural fluid with a high amylase level disappeared, and pancreatic pseudocyst was reduced with such treatments. Pancreatic pseudocyst was considered as one of the differential diagnoses of pleural effusion, especially with black pleural fluid.

KEYWORDS

Mediastinal pancreatic pseudocyst  Pancreatic pleural effusion  Endoscopic transpapillary drainage 

Received 12 Dec 2012 / Accepted 18 Mar 2013

AJRS, 2(4): 471-475, 2013

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