Chronic pancreatic pleural effusions and ascites.

Area of Science:

• Gastroenterology and Hepatology
• Surgical Gastroenterology

Background:

• Internal pancreatic fistulas leading to pleural effusion or ascites are rare, often resulting in delayed diagnosis.
• Fluid accumulation is typically linked to pancreatic duct disruption or pseudocyst rupture.

Purpose of the Study:

• To describe the presentation, diagnosis, and management of internal pancreatic fistulas causing pleural or peritoneal effusions.
• To highlight the utility of Wirsungography in surgical planning for these complex cases.

Main Methods:

• Retrospective review of five patients with chronic pancreatitis and associated effusions over a 20-year period.
• Utilized Wirsungography to assess pancreatic duct integrity and guide surgical intervention.

Main Results:

• Five cases of chronic pancreatitis with pleural or peritoneal effusions were identified.
• Wirsungography proved valuable in determining appropriate surgical techniques.
• Surgical intervention resulted in the complete resolution of effusions in all observed patients.

Conclusions:

• Internal pancreatic fistulas are an under-recognized cause of pleural and peritoneal effusions.
• Wirsungography is crucial for effective surgical management of these conditions.
• Surgery is an effective treatment for resolving effusions secondary to internal pancreatic fistulas.