Chronic pancreaticopleural fistulas.

Area of Science:

• Gastroenterology and Hepatology
• Thoracic Surgery

Background:

• Chronic pancreatitis can lead to rare complications like pancreaticopleural fistulas.
• Pancreaticopleural fistulas involve abnormal connections between the pancreas and the pleural space.

Observation:

• Two cases presented with recurrent left pleural effusion rich in pancreatic amylase.
• Associated symptoms included subcutaneous fat necrosis and expectoration of amylase-rich fluid.
• Endoscopic retrograde cholangiopancreatography (ERCP) was crucial for evaluating ductal morphology.

Findings:

• Both patients had chronic pancreaticopleural fistulas secondary to chronic pancreatitis.
• Recurrent pleural effusion with high amylase content was the primary clinical sign.
• Surgical treatment was effective for both patients.

Implications:

• Early diagnosis and intervention are key for managing pancreaticopleural fistulas.
• ERCP is essential for surgical planning in these complex cases.
• Surgical management offers a successful treatment option for refractory fistulas.