Background: Chronic pancreatitis is the most common etiology of pancreaticopleural fistula (PPF) in children, and underlying genetic variations are now widely known, accounting for most chronic pediatric pancreatitis.
Case Report: We describe a case of previously undetected chronic pancreatitis and PPF with a variation in a 10-year-old Thai boy who presented with massive left pleural effusion. Magnetic resonance cholangiopancreatography (MRCP) revealed disruption of the pancreatic duct, which was communicating with a large pancreatic pseudocyst with mediastinal extension. The patient subsequently underwent endoscopic intervention with improved clinical symptoms. We also reviewed the imaging findings of 12 other reported cases of pediatric PPF.
Conclusions: Massive pleural effusion due to PPF can be an atypical manifestation in children with chronic pancreatitis. MRCP is the preferable imaging study for PPF due to the production of highly detailed images of pancreatic duct disruptions and anatomy, and the imaging is helpful to guide for appropriate treatment. Tests for genetic variation are also recommended in a child with chronic pancreatitis.
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http://dx.doi.org/10.2478/abm-2022-0012 | DOI Listing |
Gastroenterology
December 2024
Surgical and Translational Research Centre, Faculty of Medicine and Health Science, University of Auckland, New Zealand.
United European Gastroenterol J
December 2024
IRCCS San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy.
Autoimmune pancreatitis is an increasingly recognized inflammatory type of subacute pancreatitis; two subtypes of autoimmune pancreatitis have been identified so far: the "lymphoplasmacytic" type 1 variant and the "neutrophilic" type 2 variant. Type 1 autoimmune pancreatitis represents the most common manifestation of IgG4-related disease, a fibro-inflammatory disorder characterized by elevated IgG4 levels in the serum and affected tissues. Type 2 autoimmune pancreatitis is a pancreas-specific disorder that frequently occurs in the context of inflammatory bowel diseases.
View Article and Find Full Text PDFMol Med
December 2024
Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Pancreatic diseases pose considerable health challenges due to their complex etiology and limited therapeutic options. Mitochondrial uncoupling protein 2 (UCP2), highly expressed in pancreatic tissue, participates in numerous physiological processes and signaling pathways, indicating its potential relevance in these diseases. Despite this, UCP2's role in acute pancreatitis (AP) remains underexplored, and its functions in chronic pancreatitis (CP) and pancreatic steatosis are largely unknown.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Gastroenterology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
Rationale: Pancreaticopleural fistula (PPF) is an infrequent etiology of pleural effusion, characterized by nonspecific thoracic symptoms, which often leads to misdiagnosis and subsequent severe complications. Consequently, early diagnosis is crucial for effective management and the prevention of adverse outcomes. This report presents a rare case of PPF causing bilateral pleural effusions, aiming to enhance clinical recognition of this condition.
View Article and Find Full Text PDFUnited European Gastroenterol J
December 2024
Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Goettingen, Göttingen, Germany.
Chronic pancreatitis is a fibroinflammatory disease of the pancreas with heterogeneous clinical features and a significant socioeconomic burden. Assessing its aetiology and early diagnosis of associated complications remain challenging. Personalized therapy necessitates precise knowledge of the genetic, biological, and clinical differences within a patient population.
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