A case of mediastinal pancreatic pseudocyst rupture with right intrathoracic bleeding

DOI
  • Tamura Shinobu
    Department of Emergency and Critical Care Medicine, Wakayama Medical University Department of Internal Medicine, Kinan Hospital
  • Mushino Toshiki
    Department of Internal Medicine, Kinan Hospital Department of Hematology/Oncology, Wakayama Medical University Community Medical Support Center, Wakayama Medical University

Bibliographic Information

Other Title
  • 右胸腔内出血を伴った縦隔内膵仮性嚢胞穿破の 1 例

Abstract

A 75-year-old man was referred to our hospital due to shortness of breath on exertion. Laboratory findings showed mild anemia and mild elevation of serum amylase. Chest X-ray revealed right, massive, bloody, pleural effusion. Contrast-enhanced computed tomography (CECT) revealed pancreatic pseudocysts but did not show extravasation. Local anesthetic thoracoscopy could not show the tumor or the active bleeding in the pleural space. After this procedure, CECT showed a pancreatic pseudocyst containing air. This finding suggest that this cyst was communicated to the thoracic cavity via the mediastinum. His pleural fluid amylase level was very high (17,710 IU/L). This patient was finally diagnosed with chronic alcoholic pancreatitis and a rupture of a mediastinal pancreatic pseudocyst with right intrathoracic bleeding. Conservative treatment of his acute pancreatitis resulted in clinical improvement. A mediastinal pancreatic pseudocyst with pleural effusion or intrathoracic bleeding is a rare but important complication associated with chronic pancreatitis.

Journal

Keywords

Details 詳細情報について

  • CRID
    1390860786075114240
  • DOI
    10.60227/jhgmwabun.19.3_190
  • ISSN
    27587878
    21858136
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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