Derrame pleural izquierdo por fístula de origen pancreático: reporte de caso clínico y revisión breve de literatura médica

Abstract

Among the rarest and most infrequent complications of chronic pancreatitis are pancreatic-pleural fistulas, which occur in 0.04% of the population. We describe a clinical case of a patient of a 59-year-old male with a history of recurrent episodes of acute pancreatitis, which began with a 2-month history of acute respiratory distress associated with massive left pleural effusion. Thoracentesis was performed where around 2,500 ml of exudative-type fluid were drained and coinfection by Pseudomonas putida was evidenced by pleural culture, which was covered with Meropenem 500 mg every 8 hours IV for 14 days. Subsequently, an abdominal computerized tomography (CT) scan without contrast was performed, where show a pancreatic pseudocyst and cholangio pancreatic endoscopic resonance (CPER) is observed, which shows an abnormal pancreatogram with contrast medium leakage between the head and tail, for which a stent is placed in pancreatic-biliary tract.