대량 우측 흉막 삼출로 발현한 알코올성 만성 췌장염 1예

Abstract

Patients with chronic pancreatitis develop massive pleural effusion in less than 1% and its frequency as the first clinical manifestation of the disease is unknown. Moreover, pleural effusions associated with pancreatitis are usually left-sided because the pancreas is more intimately related to the left hemidiaphragm than to the right. Recently, we experienced a case of massive right pleural effusion as the first manifestation of chonic alcoholic pancreatitis in a 39 year-old man. Pancreatic pleural effusion was diagnosed by combination of high pancreatic enzyme levels in the pleural fluid and imaging findings. A conservative management including fasting, total parenterl nutrition, and octreotide administration subcutaneously (100μg, t.i.d.) resulted in a complete recovery of the patient, We herein report this unusual manifestation of chronic alcoholic pancreatitis and discuss the therapeutic issues related to pancreatic fistulas, (Korean J Gastrointest Endosc 2001;22:126 - 130)