A rare case of pediatric pleural effusion: Pancreaticopleural fistula

Yu, Yanping; Yu, Zhenxi; Huang, Xu

doi:10.1002/ppul.24191

Cited by 6 publications

(10 citation statements)

References 4 publications

(13 reference statements)

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“…If the patient does not respond well after two or three weeks of treatment, or if symptoms progress, interventional therapies such as ERP and surgical management should be considered. Endoscopic retrograde pancreatography with stent placement is preferred in adults because it is less invasive, but only a few successful cases in children have been reported [ 7 , 11 , 24 ]. Decreasing the ductal pressure and sealing the leakage site are the main benefits of the ductal stent.…”

Section: Discussionmentioning

confidence: 99%

“…In adults, PPF is usually caused by alcohol-induced CP and acute necrotizing pancreatitis, which has an incidence of 0.4% in patients presenting with CP [ 2 , 3 ]. In children, there is insufficient data on the incidence and causes of PPF, such as acute pancreatitis (blunt trauma and unknown causes) and CP (ductal anomalies, PRSS1 mutation, and unknown causes) [ 4 – 11 ]. PPF may initially present with a shortness of breath, dyspnea, or chest tightness, with or without a history of abdominal pain or steatorrhea.…”

Section: Introductionmentioning

confidence: 99%

“…Conservative, surgical, or endoscopic management treatment modalities are available [ 12 – 15 ]. However, endoscopic management of pediatric patients with PPF remains uncommon [ 8 , 9 , 11 , 15 ]. This report presented a young child whom failed conservative and needed to further management of PPF.…”

Section: Introductionmentioning

confidence: 99%

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Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

et al. 2021

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Background Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis (CP) that requires a high index of clinical suspicion in the patient who presents with a pleural effusion. Visualizing the fistula tract from the pancreatic duct to the pleural space by radiological imaging provides confirmation of this complication. Case presentation A 9-year-old boy who presented with massive right pleural effusion secondary to PPF, a complication of CP from a genetic mutation involving two mutations of SPINK1. We successfully managed the case with by endoscopic pancreatic duct stent placement after failure of conservative treatment approaches. Conclusions PPF is a rare but serious complication of CP in all ages. The diagnosis of PPF in children requires a high index of clinical suspicion and should be considered in the differential diagnosis of massive pleural effusion where pancreatic pathology is present. A high level of pleural fluid amylase and the results from radiological imaging when the patients have symptoms play essential roles in the diagnosis of PPF. Currently, Magnetic resonance cholangiopancreatigraphy (MRCP) is the imaging modality of choice. Endoscopic therapy and surgery are treatment options for patients who do not respond to conservative therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

et al. 2021

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“…Misdiagnosis is common with these lesions, and mortality is high 21 . Yu et al 22 reported pancreaticopleural fistula as a complication of chronic pancreatitis in an 8‐year old. Magnetic resonance cholangiopancreatography confirmed connection between the pleural space and the pancreatic duct.…”

Section: Introductionmentioning

confidence: 99%

Pediatric pulmonology 2019 year in review: rare and diffuse lung disease

Gower

Vece

2021

Pediatric Pulmonology

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Pediatric Pulmonology publishes original research, review articles, and case reports on topics related to a wide range of children's respiratory disorders. Here we review manuscripts published in 2019 in this journal and others on (1) anatomic lung, airway, and vascular malformations, (2) children's interstitial lung disease, and (3) primary ciliary dyskinesia and non-cystic fibrosis bronchiectasis.

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“…Statistical summary of imaging findings of the reported cases of PPF in children including our case. Total patients (n = 13)[1,2,[8][9][10][11][12][13][14][15][16].…”

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confidence: 99%

Pancreaticopleural fistula in a Thai boy with SPINK1 c.101A>G substitution variant-related chronic pancreatitis: a case report and literature review

2022

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Background Chronic pancreatitis is the most common etiology of pancreaticopleural fistula (PPF) in children, and underlying genetic variations are now widely known, accounting for most chronic pediatric pancreatitis. Case report We describe a case of previously undetected chronic pancreatitis and PPF with a SPINK1 variation in a 10-year-old Thai boy who presented with massive left pleural effusion. Magnetic resonance cholangiopancreatography (MRCP) revealed disruption of the pancreatic duct, which was communicating with a large pancreatic pseudocyst with mediastinal extension. The patient subsequently underwent endoscopic intervention with improved clinical symptoms. We also reviewed the imaging findings of 12 other reported cases of pediatric PPF. Conclusions Massive pleural effusion due to PPF can be an atypical manifestation in children with chronic pancreatitis. MRCP is the preferable imaging study for PPF due to the production of highly detailed images of pancreatic duct disruptions and anatomy, and the imaging is helpful to guide for appropriate treatment. Tests for genetic variation are also recommended in a child with chronic pancreatitis.

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A rare case of pediatric pleural effusion: Pancreaticopleural fistula

Cited by 6 publications

References 4 publications

Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants

Pediatric pulmonology 2019 year in review: rare and diffuse lung disease

Pancreaticopleural fistula in a Thai boy with SPINK1 c.101A>G substitution variant-related chronic pancreatitis: a case report and literature review

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