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A case of complete resolution of mediastinal pseudocyst and pleural effusion by endoscopic stenting of pancreatic duct.

Authors
 Dong-Ju Kim  ;  Hye-Won chung  ;  Chang-Woo Gham  ;  Ho-Gyun Na  ;  Seung-Woo Park  ;  Se-Jun Lee  ;  Jun-Pyo chung  ;  Si-Young Song  ;  Jae-Bock Chung  ;  Jin-Kyoung Kang 
Citation
 Yonsei Medical Journal, Vol.44(4) : 727-731, 2003 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2003
MeSH
Endoscopy* ; Humans ; Male ; Mediastinal Neoplasms/complications* ; Mediastinal Neoplasms/diagnostic imaging ; Mediastinal Neoplasms/therapy ; Middle Aged ; Pancreatic Ducts* ; Pancreatic Pseudocyst/complications* ; Pancreatic Pseudocyst/diagnostic imaging ; Pancreatic Pseudocyst/therapy ; Pleural Effusion/complications* ; Pleural Effusion/therapy ; Radiography, Thoracic ; Stents* ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Mediastinal ; pancreatic pseudocyst ; pleural effusion ; stents ; pancreatic ducts
Abstract
We report a case of a mediastinal pseudocyst with a pleural effusion that developed in a patient suffering from alcohol- related chronic pancreatitis. A 53-year-old man was admitted to another institution complaining of pleuritic chest pain and coughing. A chest X-ray revealed a pleural effusion with a collapse of the right middle and lower lobes. Pleural fluid taken by thoracentesis was exudative, and the patient was transferred to our institution. A CT scan showed a loculated cystic lesion in the mediastinum and pancreatic changes that were consistent with chronic pancreatitis. The endoscopic retrograde cholangiopancreatography (ERCP) findings were compatible with chronic pancreatitis showing severe pancreatic ductal stricture at the head with an upstream dilation and distal bile duct stricture. After a one week of treatment with fasting and octreotide without improvement, both pancreatic and biliary stents were placed endoscopically. After stenting, the pleural effusion and pseudocyst rapidly resolved. The stents were changed 3 months later, at which time a repeated CT demonstrated a complete resolution of the pseudocyst. Since the initial stenting, he has been followed up for 7 months and is doing well with no recurrence of the symptoms, but he will need to undergo regular stent changes. Overall, endoscopic pancreatic stenting appears to be a good option for managing selected cases of mediastinal pancreatic pseudocysts.
Files in This Item:
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DOI
10.3349/ymj.2003.44.4.727
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165593
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