A case of pancreatic-pleural fistula of Type 1 autoimmune pancreatitis successfully treated with pancreatic drainage and steroid

Clinical Journal of Gastroenterology volume 13, pages946–950(2020)Cite this article

Abstract

Pancreatic-pleural fistula is a rare but severe complication with pancreatitis. A 50-year old man with heavy alcoholic history was transferred to our hospital due to pancreatic pleural effusion with diffuse pancreatic swelling. MRCP revealed two stenotic parts of main pancreatic duct. We inserted a pancreatic stent, and pleural effusion was improved. However, diffuse pancreatic swelling still remained for 3 months. Autoimmune pancreatitis was suspected because of morphologic appearance and high serum levels of IgG4. We confirmed his illness as Type 1 autoimmune pancreatitis pathologically by EUS-FNA and started steroid administration. Diffuse pancreatic swelling was improved immediately. Pancreatic-pleural fistula did not relapse after removing the pancreatic stent and tapering steroid. This is a first report for pancreatic-pleural fistula caused by autoimmune pancreatitis and successfully treated with pancreatic drainage and steroid.

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Abbreviations

EUS-FNA:

Endoscopic ultrasonography-guided fine-needle aspiration

AIP:

Autoimmune pancreatitis

CT:

Computed tomography

MRCP:

Magnetic resonance cholangiopancreatography

ERCP:

Endoscopic retrograde cholangiopancreatography

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Acknowledgements

This study was not supported by any funding.

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Affiliations

  1. Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan

    Naoyuki Hasegawa, Yuji Yamaguchi, Junji Hattori, Masato Endo, Kazunori Ishige, Kuniaki Fukuda & Ichinosuke Hyodo

  2. Endoscopic Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan

    Yuji Mizokami

Authors
  1. Naoyuki Hasegawa
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  2. Yuji Yamaguchi
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  3. Junji Hattori
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  4. Masato Endo
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  5. Kazunori Ishige
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  6. Kuniaki Fukuda
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  7. Ichinosuke Hyodo
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  8. Yuji Mizokami
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Corresponding author

Correspondence to Naoyuki Hasegawa.

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Conflict of interest

Naoyuki Hasegawa, Yuji Yamaguchi, Junji Hattori, Masato Endo, Kazunori Ishige, Kuniaki Fukuda, Ichinosuke Hyodo, and Yuji Mizokami declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 declaration of Helsinki and its later amendments.

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Hasegawa, N., Yamaguchi, Y., Hattori, J. et al. A case of pancreatic-pleural fistula of Type 1 autoimmune pancreatitis successfully treated with pancreatic drainage and steroid. Clin J Gastroenterol 13, 946–950 (2020). https://doi.org/10.1007/s12328-020-01125-4

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Keywords

  • Pancreatic-pleural fistula
  • Autoimmune pancreatitis
  • Steroid
  • Pancreatic stent
  • EUS-FNA