CASE REPORT   

Chirurgia 2019 February;32(1):45-7

DOI: 10.23736/S0394-9508.18.04854-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

A management dilemma of pancreaticopleural fistula in the era of bariatric surgery

Yasser ALJEHANI ¹ ✉, Abdullah ALQATTAN ², Mohammed ALISMAIL ¹

¹ Division of Thoracic Surgery, Department of Surgery, King Fahad University Hospital, Imam Abdurrahman Bin Faisal University, Dammam, Saudi Arabia; ² King Fahad University Hospital, Imam Abdurrahman Bin Faisal University, Dammam, Saudi Arabia

Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis. PPF is treated by pancreatic stenting, but in cases of altered gastrointestinal anatomy endoscopic retrograde cholangiopancreatography is inapplicable. Moreover, the open route is difficult in mesh repair of abdominal wall hernia. We report a case of 35-year-old female who underwent biliopancreatic diversion, which was complicated later on by attacks of pancreatitis and pancreatic pseudocyst which was complicated by formation of PPF. Successful conservative management was achieved although prolonged due to the inability of pancreatic stenting. This case demonstrates the rarity of such condition and the challenges faced due to altered gastrointestinal tract anatomy.

KEY WORDS: Bariatric surgery - Biliopancreatic diversion - Pancreatic fistula - Pleural effusion