Mediastinal Necrosis in Acute Pancreatitis - Case Report

Stimac, Davor; Nikšić, Maida; Mijandrusić, B Sincić; Depolo, Arsen; Uravić, Miljenko; Grbas, Harry; Perić, Rosana Troskot; Miletić, Damir; Kardum, L Bulat

doi:10.1055/s-2007-960660

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…Pancreatitis is an extremely uncommon etiology for acute mediastinitis, and only a few case reports have described this rare complication. [82][83][84] The underlying mechanism is similar to that leading to internal fistulae with the extension of pancreatic secretions into the mediastinum. It is seen as extensive mediastinal fat stranding on CT. Management is similar to that of internal pancreatic fistula.…”

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

“…Descending mediastinitis from the infections of the oral cavity and pharynx is less common. Pancreatitis is an extremely uncommon etiology for acute mediastinitis, and only a few case reports have described this rare complication . The underlying mechanism is similar to that leading to internal fistulae with the extension of pancreatic secretions into the mediastinum.…”

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

“…It is seen as extensive mediastinal fat stranding on CT. Management is similar to that of internal pancreatic fistula. Stimac et al reported mediastinal necrosis in a patient with alcohol‐related acute pancreatitis and massive right pleural effusion . They managed the patient with octreotide; however, the patient succumbed to his illness.…”

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

“…Stimac et al reported mediastinal necrosis in a patient with alcohol-related acute pancreatitis and massive right pleural effusion. 82 They managed the patient with octreotide; however, the patient succumbed to his illness. Chong et al reported a patient of alcohol-related acute pancreatitis who had clinical worsening and progressive mediastinal fat necrosis on CT. 83 This patient also had progressive intraluminal thrombus within the ascending aorta.…”

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

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Thoracic complications of pancreatitis

2018

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Acute pancreatitis in its severe form may lead to systemic inflammatory response syndrome and multisystem organ dysfunction. Acute lung injury is an important cause of mortality in the setting of severe acute pancreatitis. Besides lung involvement, acute and chronic pancreatitis may also lead to the involvement of other thoracic compartments, including mediastinum, pleura, and vascular structures. These manifestations are an important cause of morbidity and may pose diagnostic and therapeutic challenges. These manifestations have not been discussed in detail in the available literature. In this review, we discuss the thoracic complications of pancreatitis, including lung, pleural, mediastinal, and vascular manifestations.

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Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

Section: Mediastinal and Vascular Complicationsmentioning

confidence: 99%

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Thoracic complications of pancreatitis

2018

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“…Mortality is approximately 15% in patients with necrotizing pancreatitis and in cases with infected necrosis up to 30-39% [3][4][5]. Mediastinal necrosis is a rare complication of AP and only few cases have been reported until now [6][7][8]. The common thoracic complications of AP are pleural effusions and pneumonia [9,10].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2019

SCSOAJ

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Mediastinal abscess formation is a rare thoracic complication of acute pancreatitis with a high mortality. Pleural effusion and pneumonia represent the most frequent complications. Here we report the case of a 52 years old patient with a history of alcoholinduced acute pancreatitis, who was admitted at our hospital with acute abdominal pain. Contrast-enhanced Computed Tomography showed a necrotizing pancreatitis with mediastinal abscess formation. Endosonographic puncture and subsequent placement of a transesophageal pigtail drainage in the necrotic cavity led to complete evacuation of the infected mediastinal necrosis. To our knowledge this therapeutic approach has not been described for such a case before and seems to be an effective therapy of mediastinal abscess formation.

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Enzymatic mediastinitis as a fearsome complication of pancreatic necrosectomy

García-Señoráns¹,

Villar²,

Rı́o³

et al. 2018

Rev Esp Enferm Dig

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Several types of thoracic complications can be associated with severe acute pancreatitis. Some are very common, such as pleural effusion, whilst some others are very rare although life threatening, such as enzymatic mediastinitis (EM). Only a few cases of EM (when related to acute pancreatitis) have been described in the literature. Here we describe the case of a 76-year-old female who developed acute respiratory failure and atrial fibrillation during the postoperative period after an open pancreatic necrosectomy, due to an EM episode. The mediastinal collection was drained by thoracotomy, following an improvement of the patient's general condition. This is the first case of EM following surgical management for acute necrotizing pancreatitis. EM is a rare but life threatening complication that usually requires surgery.

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Mediastinal Necrosis in Acute Pancreatitis - Case Report

Cited by 4 publications

References 7 publications

Thoracic complications of pancreatitis

Thoracic complications of pancreatitis

Untitled

Enzymatic mediastinitis as a fearsome complication of pancreatic necrosectomy

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