Pancreaticothoracic Fistula 인하대병원 소화기내과 전임의 김성현

M/56 Chief Complaint : Hemoptysis Present Illness 소량의 blood-tinged sputum 있어 오다 내원 당일 소주컵 분량의 hemoptysis 있어 내원함 Past Medical History DM/HTN (+/+)

Social History chronic alcoholics(소주 2병/day) Review of System Cough/Sputum (+/+), Hemoptysis (+) Dyspnea (-), Chest pain (-), Abdominal pain (-) Physical Examination Coarse breath sound, Rt lung (+)

Laboratory findings on admission CBC : 8730(75.4%)-8.6-279K AST/ALT : 45/11 T.bilirubin : 0.7 Albumin : 4.2 Alk phosphatase : 273 Na/K/Cl : 135/4.7/98

퇴원 일주일 후 내원 Chest pain and dyspnea for 3 days.

ENPD 10일후

Pancreaticothoracic Fistula uncommon but serious complication of acute and chronic pancreatitis or pancreatic trauma 4 types : pancreaticopleural, mediastinal pseudocyst, pancreaticobronchial, and pancreaticopericardial.

Pancreaticothoracic Fistula Chest symptoms or pleural effusion + History of pancreatitis or alcoholism  Suspicious Pancreaticothoacic fistula MRCP is the better initial choice for being a noninvasive procedure Restoring anatomic continuity is important if conservative fails