1. Pancreaticothoracic Fistula
인하대병원 소화기내과
전임의 김성현

2. 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 (+/+)

3. 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 (+)

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

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

12. ENPD 10일후

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

15. 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