Management of Mediastinal Pancreatic Fluid Collections by Endoscopic Pancreatic Ductal Decompression

Zuozheng Wang

doi:10.26717/bjstr.2020.28.004650

Abstract

Weijie Yao1, Shiyang Ma2, Wenping Bo1 and Zuozheng Wang1* Author Affiliations 1Department of Hepatobiliary Surgery of the General Hospital of NingXia Medical University, China 2Department of Gastroenterology, the Second Affiliated Hospital of Xi’an Jiaotong University, China Received: June 11, 2020 | Published: June 22, 2020 Corresponding author: Zuozheng Wang, Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, China DOI: 10.26717/BJSTR.2020.28.004650

Highlights

We suggest endoscopic main pancreatic duct decompression is a safe and efficient treatment in the management of mediastinal collections associated with pancreatic diseases
Acute peri-pancreatic fluid collection and pancreatic pseudocyst can develop after pancreatitis
A history of pancreatitis or pancreatic pseudocyst may help in the diagnostic workup

Summary

Introduction

Acute peri-pancreatic fluid collection and pancreatic pseudocyst can develop after pancreatitis. The authors report 3 cases of pancreatic mediastinal fluid collection. After successful drainage of the pancreatic duct, the mediastinal fluid collections resolved and no additional treatment was necessary. This report further supports the concept that decompression of main pancreatic duct may be valuable in managing pancreatic complications. Age/Sex Etiology Acute/Chronic pancreatitis Abdominal pancreatic pseudocyst Associated complications Pulmonary infection White cell count (×109/L) HGB (g/L) PLT (×109/L). Between September 2017 and May 2018, a total of 3 patients developed mediastinal pancreatic fluid collections after pancreatitis. The CT scans showed mediastinal fluid collections (Figure 1). Endoscopic main pancreatic duct decompression was performed by placement of nasobiliary tube or nasopancreatic tube, or pancreatic stent. All patient recovered uneventfully with the disappear of symptoms as well as mediastinal pancreatic fluid collection (Figure 1)

Discussion

Conclusion