ERP IN PATIENTS WITH PANCREATIC PLEURAL EFFUSION

Abstract

Three cases of pancreatic pleural effusion were reported with endoscopic retrograde pancreatography (ERP). The first Patient, a 41-year-old man, had acute pancreatitis and his pleural effusion was small and self-limited on the right side. This disappeared as the acute attack of pancreatitis subsided. ERP showed no abnormality. The second patient, a 48-year-old man, was admitted because of shortness of breath. A roentgenogram of the chest showed massive left pleural effusion and he was treated medically. ERP, however, failed to show the leakage of contrast medium although a big pseudocyst on the head of pancreas was seen. The third patient, a 46-year-old man, was admitted, the chief complaint being shortness of breath and cough. ERP successfully demonstrated a pancreatic duct disruption and pleuromediastinum fistula which was trucked up along the aortic hiatus. Because effusion recurred deispite repeated taps, Roux-en-Y pancreaticojejunostomy was performed. The effusion subsided after the operation. It was emphasized that ERP was an essential procedure in this chronic pancreatic pleural effusion entity. On the other hand, in the setting of self-limited effusion, which has few clinical problems and subsides soon, ERP has a minimum value.