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Pancreaticopleural fistula: a rare thoracic complication of pancreatic duct disruption.

Duncan ND, Ramphal PS, Dundas SE, Gandreti NK, Robinson-Bridgewater LA, Plummer JM

Department of Surgery, University Hospital of the West Indies, Kingston, Jamaica. newton.duncan@uwimona.edu.jm

Pancreaticopleural fistula resulting in a chronic pleural effusion is a rare complication of pancreatic duct disruption. We describe the presentation and management of 2 children with pancreaticopleural fistulas. Pleural fluid amylase concentration and contrast computed tomography were sufficient to establish the diagnosis in both cases. The initial management of these fistulas should be conservative, by tube thoracostomy and suppression of pancreatic secretion. Operative treatment is necessary for those who fail to resolve. Complete diversion of the pancreatic juice into the gastrointestinal tract by longitudinal pancreaticojejunostomy has been an effective surgical option leading to fistula closure.

Published 6 March 2006 in J Pediatr Surg, 41(3): 580-2.
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