A pancreaticopleural fistula is a rare cause of pleural effusion. It is a complication of chronic or acute pancreatitis. It is rarely formed to the right or both pleural cavities. Diagnosis and proper treatment often turn out to be difficult and require the cooperation of a multidisciplinary team. The authors present the case of a 59-year-old patient treated for recurrent pleural effusion of unknown origin, first to the left and then to the right pleural cavity. After many months of treatment, the diagnosis of a pancreaticopleural fistula was made. The patient underwent surgery, which finally led to a successful complete recovery. Pancreaticopleural fistula should always be considered in patients with pleural effusion of unknown origin.
Pilonidal disease is a particularly difficult disorder to treat. Guidelines and recommendations for the treatment of pilonidal disease neglect the use of negative pressure wound therapy (NPWT), but studies strongly support the role of NPWT in preventing surgical site infection in high-risk patients.During a webinar on the pilonidal disease, we asked 51 participants to complete a questionnaire about the treatment of pilonidal disease. They answered questions about treatment practices for patients with a pilonidal disease, and the use of NPWT.The study showed that a relatively large number of surgeons use NPWT to treat patients with the pilonidal disease. The majority of them are satisfied with maintaining the tightness and effectiveness of a vacuum dressing and would use the single-use NPWT systems if they were more easily available and affordable. It seems that the NPWT in the pilonidal disease is increasingly used and this method is gaining popularity among practitioners.
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