43:
194:
First described by Smith (1953), and elaborated upon by
Cameron et al. (1976), internal pancreatic fistulas can result in pancreatic ascites, mediastinital pseudocysts, enzymatic mediastinitis, or pancreatic pleural effusions, depending on the flow of pancreatic secretions from a disrupted pancreatic
117:
Anterior disruption of a pseudocyst or a pancreatic duct leads to leakage of pancreatic secretions into the free peritoneal cavity, leading to pancreatic ascites. If the duct is disrupted posteriorly, the secretions leak through the retroperitoneum into the mediastinum via the aortic or esophageal
113:
Internal pancreatic fistulas are most commonly caused by disruption of the pancreatic duct due to chronic pancreatitis. The chronic pancreatitis is usually alcoholic in origin in adults, and traumatic in origin in children. They may also be caused by leakage from a pancreatic pseudocyst.
88:
pancreatic fistula is one that communicates with the skin, and is also known as a pancreaticocutaneous fistula, whereas an internal pancreatic fistula communicates with other internal organs or spaces. Pancreatic fistulas can be caused by pancreatic disease, trauma, or surgery.
211:. This treatment is continued for 2–3 weeks, and the patient is observed for improvement. If no improvement is seen, the patient may receive endoscopic or surgical treatment. If surgical treatment is followed, an ERCP is needed to identify the site of the leak.
523:
138:
level, usually > 1,000 IU/L, with protein levels over 3.0 g/dL is diagnostic. Serum amylase is often elevated as well, due to enzyme diffusion across the peritoneal or pleural surface. Contrast-enhanced
1399:
577:
118:
hiatus. Once in the mediastinum, the secretions can either be contained in a mediastinal pseudocyst, lead to enzymatic mediastinitis, or, more commonly, leak through the
1081:
434:
Kaman L, Behera A, Singh R, Katariya RN (2001). "Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management".
144:
676:
715:
397:
Iacono C, Procacci C, Frigo F, Andreis IA, Cesaro G, Caia S, Bassi C, Pederzoli P, Serio G, Dagradi A (1989). "Thoracic complications of pancreatitis".
203:
The production of pancreatic enzymes is suppressed by restricting the patient's oral intake of food patient in conjunction with the use of long-acting
186:. Loss of a small volume of fluid will not cause a problem but an acidosis is common if the volume of pancreatic fluid lost from the body is large.
570:
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Dugernier T, Laterre PF, Reynaert MS (2000). "Ascites fluid in severe acute pancreatitis: from pathophysiology to therapy".
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Takeo C, Myojo S (2000). "Marked effect of octreotide acetate in a case of pancreatic pleural effusion".
1670:
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320:
Smith EB (1953). "Hemorrhagic ascites and hemothorax associated with benign pancreatic disease".
183:
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147:(ERCP) may also assist in diagnosis, with the latter an essential component of treatment.
81:
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333:
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204:
543:
214:
Fistulectomy is done in which the involved part of the pancreas is also removed.
1823:
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1563:
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958:
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1183:
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873:
271:
161:
77:
515:
238:"Internal pancreatic fistulas: pancreatic ascites and pleural effusions"
160:
An external pancreatic fistula is an abnormal communication between the
1235:
1001:
905:
877:
176:
135:
102:
73:
80:
and other organs due to leakage of pancreatic secretions from damaged
1701:
1319:
1205:
119:
1151:
881:
134:
Pleural or ascitic fluid should be sent for analysis. An elevated
559:
101:
is a major clinical manifestation, and unresponsiveness of the
285:
Lipsett PA, Cameron JL (1992). "Internal pancreatic fistula".
364:(1st ed.). Philadelphia: WB Saunders. pp. 230–232.
360:
Brooks JR (1983). "Pancreatic ascites". In Brooks JR (ed.).
27:
Leakage of pancreatic secretions into other organs or spaces
236:
Cameron JL, Kieffer RS, Anderson WJ, Zuidema GD (1976).
168:) and the exterior of the body via the abdominal wall.
505:
207:
analogues. The patient's nutrition is maintained by
1814:
1700:
1693:
1634:
1548:
1505:
1351:
1342:
1295:
1249:
1204:
1090:
977:
867:
854:
729:
603:
594:
509:
54:
35:
122:to enter the chest and form a chronic pancreatic
105:to diuretics is an additional diagnostic clue.
145:endoscopic retrograde cholangiopancreatography
571:
8:
677:Esophagogastric junction outflow obstruction
1697:
1348:
864:
716:Esophageal intramural pseudodiverticulosis
600:
578:
564:
556:
506:
179:can result in a hyperchloraemic or normal
41:
32:
261:
231:
229:
227:
175:-rich pancreatic fluid via a pancreatic
223:
944:Small intestinal bacterial overgrowth
7:
334:10.1001/archsurg.1953.01260040055008
195:duct or leakage from a pseudocyst.
25:
1829:Spontaneous bacterial peritonitis
1676:Exocrine pancreatic insufficiency
1574:Secondary sclerosing cholangitis
448:10.1046/j.1440-1622.2001.02077.x
411:10.1097/00006676-198904000-00012
254:10.1097/00000658-197611000-00009
815:Gastric antral vascular ectasia
810:Portal hypertensive gastropathy
687:Gastroesophageal reflux disease
1569:Primary sclerosing cholangitis
1419:Hepatic veno-occlusive disease
1241:Solitary rectal ulcer syndrome
1:
1626:Sphincter of Oddi dysfunction
1535:Postcholecystectomy syndrome
1054:Intestinal pseudoobstruction
662:Esophageal motility disorder
299:10.1016/0002-9610(92)90104-Y
18:Pancreaticoduodenal fistula
1882:
1520:Gallstone / Cholelithiasis
1044:Functional colonic disease
840:Zollinger–Ellison syndrome
485:10.1185/030079900750120269
209:total parenteral nutrition
721:Acute esophageal necrosis
49:
40:
820:Gastric dumping syndrome
695:Laryngopharyngeal reflux
682:Diffuse esophageal spasm
1436:Alcoholic liver disease
969:Bile acid malabsorption
913:Peptic (duodenal) ulcer
378:Acta Gastroenterol Belg
362:Surgery of the Pancreas
1446:Hepatic encephalopathy
830:Buried bumper syndrome
761:Peptic (gastric) ulcer
645:Mallory–Weiss syndrome
588:human digestive system
74:abnormal communication
1671:Pancreatic pseudocyst
1540:Porcelain gallbladder
652:Zenker's diverticulum
1475:Hepatorenal syndrome
1414:Budd–Chiari syndrome
1371:Autoimmune hepatitis
1196:Intestinal adhesions
954:Short bowel syndrome
783:Functional dyspepsia
701:Esophageal stricture
667:Nutcracker esophagus
1614:Choledocholithiasis
1485:Metabolic disorders
1451:Acute liver failure
1424:Portal hypertension
1376:Alcoholic hepatitis
1219:Radiation proctitis
1138:Mesenteric ischemia
1110:Gastroenterocolitis
939:Blind loop syndrome
749:Ménétrier's disease
657:Barrett's esophagus
141:computed tomography
50:Anatomy of pancreas
1866:Pancreas disorders
1789:Undefined location
1780:Grynfeltt–Lesshaft
1681:Pancreatic fistula
1664:Pancreatic abscess
1619:Biliary dyskinesia
1590:Mirizzi's syndrome
1091:Large and/or small
771:Dieulafoy's lesion
640:Boerhaave syndrome
184:metabolic acidosis
93:Signs and symptoms
70:pancreatic fistula
36:Pancreatic fistula
1853:
1852:
1849:
1848:
1689:
1688:
1291:
1290:
1148:Bowel obstruction
850:
849:
553:
552:
473:Curr Med Res Opin
66:
65:
30:Medical condition
16:(Redirected from
1873:
1841:Pneumoperitoneum
1698:
1608:Common bile duct
1490:Wilson's disease
1480:Peliosis hepatis
1349:
1226:Proctalgia fugax
1133:Abdominal angina
1058:Ogilvie syndrome
1007:Pseudomembranous
865:
825:Gastric volvulus
790:Pyloric stenosis
601:
586:Diseases of the
580:
573:
566:
557:
507:
496:
467:
430:
393:
365:
346:
345:
317:
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233:
124:pleural effusion
82:pancreatic ducts
45:
33:
21:
1881:
1880:
1876:
1875:
1874:
1872:
1871:
1870:
1856:
1855:
1854:
1845:
1810:
1799:Internal hernia
1685:
1630:
1595:Biliary fistula
1553:
1544:
1530:Adenomyomatosis
1525:Cholesterolosis
1501:
1495:Hemochromatosis
1366:Viral hepatitis
1338:
1287:
1245:
1231:Rectal prolapse
1200:
1167:Fecal impaction
1157:Intussusception
1120:Crohn's disease
1086:
1069:Toxic megacolon
981:
979:Large intestine
973:
918:Curling's ulcer
871:
869:Small intestine
858:
846:
754:Gastroenteritis
725:
590:
584:
554:
549:
548:
518:
504:
499:
470:
433:
396:
375:
359:
350:
349:
319:
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284:
283:
279:
235:
234:
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201:
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166:pancreatic duct
158:
153:
132:
111:
95:
61:General surgery
31:
28:
23:
22:
15:
12:
11:
5:
1879:
1877:
1869:
1868:
1858:
1857:
1851:
1850:
1847:
1846:
1844:
1843:
1838:
1836:Hemoperitoneum
1833:
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1812:
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1809:
1808:
1807:
1806:
1801:
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1471:
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1368:
1357:
1355:
1346:
1340:
1339:
1337:
1336:
1335:
1334:
1324:
1323:
1322:
1317:
1307:
1305:Blood in stool
1301:
1299:
1293:
1292:
1289:
1288:
1286:
1285:
1280:
1278:Anal dysplasia
1275:
1270:
1265:
1255:
1253:
1247:
1246:
1244:
1243:
1238:
1233:
1228:
1223:
1222:
1221:
1210:
1208:
1202:
1201:
1199:
1198:
1193:
1192:
1191:
1181:
1180:
1179:
1169:
1164:
1159:
1154:
1145:
1143:Angiodysplasia
1140:
1135:
1124:
1123:
1122:
1112:
1107:
1106:
1105:
1094:
1092:
1088:
1087:
1085:
1084:
1078:Diverticulosis
1074:Diverticulitis
1071:
1062:
1061:
1060:
1051:
1041:
1036:
1035:
1034:
1029:
1024:
1019:
1014:
1009:
999:
993:
991:
975:
974:
972:
971:
966:
964:Milroy disease
961:
956:
951:
946:
941:
936:
934:Tropical sprue
931:
922:
921:
920:
910:
909:
908:
903:
898:
887:
885:
862:
856:Lower GI tract
852:
851:
848:
847:
845:
844:
843:
842:
832:
827:
822:
817:
812:
807:
802:
797:
792:
787:
786:
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746:
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691:
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684:
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674:
669:
659:
654:
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648:
647:
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632:
631:
630:
625:
620:
609:
607:
598:
596:Upper GI tract
592:
591:
585:
583:
582:
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568:
560:
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519:
514:
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510:Classification
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502:External links
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97:Marked recent
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29:
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1732:
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1730:
1727:
1726:
1723:
1720:
1716:
1713:
1712:
1711:
1710:Diaphragmatic
1708:
1707:
1705:
1703:
1699:
1696:
1692:
1682:
1679:
1677:
1674:
1672:
1669:
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1641:
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1637:
1633:
1627:
1624:
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1617:
1615:
1612:
1611:
1610:
1609:
1605:
1604:
1601:
1598:
1596:
1593:
1591:
1587:
1584:
1580:
1577:
1575:
1572:
1570:
1567:
1566:
1565:
1562:
1561:
1559:
1557:
1551:
1547:
1541:
1538:
1536:
1533:
1531:
1528:
1526:
1523:
1521:
1518:
1516:
1515:Cholecystitis
1513:
1512:
1510:
1508:
1504:
1496:
1493:
1491:
1488:
1487:
1486:
1483:
1481:
1478:
1476:
1473:
1469:
1466:
1464:
1461:
1460:
1459:
1458:Liver abscess
1456:
1452:
1449:
1447:
1444:
1443:
1442:
1441:Liver failure
1439:
1437:
1434:
1430:
1427:
1425:
1422:
1420:
1417:
1415:
1412:
1411:
1410:
1409:
1405:
1401:
1398:
1397:
1396:
1393:
1389:
1386:
1385:
1384:
1381:
1377:
1374:
1372:
1369:
1367:
1364:
1363:
1362:
1359:
1358:
1356:
1354:
1350:
1347:
1345:
1341:
1333:
1330:
1329:
1328:
1325:
1321:
1318:
1316:
1313:
1312:
1311:
1308:
1306:
1303:
1302:
1300:
1298:
1294:
1284:
1281:
1279:
1276:
1274:
1271:
1269:
1266:
1264:
1260:
1257:
1256:
1254:
1252:
1248:
1242:
1239:
1237:
1234:
1232:
1229:
1227:
1224:
1220:
1217:
1216:
1215:
1212:
1211:
1209:
1207:
1203:
1197:
1194:
1190:
1187:
1186:
1185:
1182:
1178:
1175:
1174:
1173:
1170:
1168:
1165:
1163:
1160:
1158:
1155:
1153:
1149:
1146:
1144:
1141:
1139:
1136:
1134:
1130:
1129:
1125:
1121:
1118:
1117:
1116:
1113:
1111:
1108:
1104:
1101:
1100:
1099:
1098:Enterocolitis
1096:
1095:
1093:
1089:
1083:
1079:
1075:
1072:
1070:
1066:
1063:
1059:
1055:
1052:
1050:
1047:
1046:
1045:
1042:
1040:
1037:
1033:
1030:
1028:
1025:
1023:
1020:
1018:
1015:
1013:
1010:
1008:
1005:
1004:
1003:
1000:
998:
995:
994:
992:
989:
985:
980:
976:
970:
967:
965:
962:
960:
957:
955:
952:
950:
947:
945:
942:
940:
937:
935:
932:
930:
926:
925:Malabsorption
923:
919:
916:
915:
914:
911:
907:
904:
902:
899:
897:
894:
893:
892:
889:
888:
886:
883:
879:
875:
870:
866:
863:
861:
857:
853:
841:
838:
837:
836:
833:
831:
828:
826:
823:
821:
818:
816:
813:
811:
808:
806:
803:
801:
800:Gastroparesis
798:
796:
793:
791:
788:
784:
781:
780:
779:
776:
772:
769:
767:
766:Cushing ulcer
764:
763:
762:
759:
755:
752:
750:
747:
745:
742:
741:
740:
737:
736:
734:
732:
728:
722:
719:
717:
714:
712:
711:Megaesophagus
709:
707:
704:
702:
699:
696:
693:
688:
685:
683:
680:
678:
675:
673:
670:
668:
665:
664:
663:
660:
658:
655:
653:
650:
646:
643:
641:
638:
637:
636:
633:
629:
626:
624:
621:
619:
616:
615:
614:
611:
610:
608:
606:
602:
599:
597:
593:
589:
581:
576:
574:
569:
567:
562:
561:
558:
545:
541:
540:
536:
534:
530:
529:
525:
521:
520:
517:
512:
508:
501:
494:
490:
486:
482:
478:
474:
469:
465:
461:
457:
453:
449:
445:
441:
437:
432:
428:
424:
420:
416:
412:
408:
405:(2): 228–36.
404:
400:
395:
391:
387:
383:
379:
374:
372:
371:0-7216-2082-5
368:
363:
358:
357:
352:
351:
343:
339:
335:
331:
327:
323:
322:AMA Arch Surg
316:
313:
308:
304:
300:
296:
293:(2): 216–20.
292:
288:
281:
278:
273:
269:
264:
259:
255:
251:
248:(5): 587–93.
247:
243:
239:
232:
230:
228:
224:
217:
215:
212:
210:
206:
198:
196:
189:
187:
185:
182:
178:
174:
169:
167:
163:
155:
150:
148:
146:
142:
137:
129:
127:
125:
121:
115:
108:
106:
104:
100:
92:
90:
87:
83:
79:
75:
71:
62:
59:
57:
53:
48:
44:
39:
34:
19:
1788:
1767:
1680:
1644:Pancreatitis
1606:
1556:biliary tree
1429:Nutmeg liver
1406:
1332:Hematochezia
1283:Pruritus ani
1268:Anal abscess
1263:Anal fistula
1259:Anal fissure
1172:Constipation
1126:
997:Appendicitis
805:Gastroptosis
795:Achlorhydria
634:
623:Eosinophilic
537:
522:
479:(3): 171–7.
476:
472:
442:(4): 221–5.
439:
435:
402:
398:
384:(3): 264–8.
381:
377:
361:
353:Bibliography
325:
321:
315:
290:
286:
280:
245:
241:
213:
205:somatostatin
202:
193:
170:
159:
133:
116:
112:
109:Pathogenesis
96:
85:
76:between the
69:
67:
1824:Peritonitis
1586:Cholestasis
1564:Cholangitis
1507:Gallbladder
1395:Fatty liver
1315:Hematemesis
1297:GI bleeding
1103:Necrotizing
1032:Lymphocytic
1027:Collagenous
1022:Microscopic
959:Steatorrhea
860:Enteropathy
706:Inlet patch
628:Herpetiform
613:Esophagitis
328:(1): 52–6.
173:bicarbonate
99:weight loss
1816:Peritoneal
1794:Incisional
1715:Congenital
1659:Hereditary
1636:Pancreatic
1600:Haemobilia
1273:Hemorrhoid
1251:Anal canal
1189:Infectious
1177:Functional
1012:Ulcerative
896:Duodenitis
835:Gastrinoma
436:ANZ J Surg
218:References
164:(actually
1804:Richter's
1761:Spigelian
1756:Obturator
1746:Umbilical
1579:Ascending
1550:Bile duct
1383:Cirrhosis
1361:Hepatitis
1344:Accessory
1214:Proctitis
1065:Megacolon
1039:Dysentery
949:Whipple's
901:Jejunitis
891:Enteritis
778:Dyspepsia
739:Gastritis
672:Achalasia
605:Esophagus
287:Am J Surg
199:Treatment
181:anion gap
130:Diagnosis
56:Specialty
1860:Category
1734:Indirect
1729:Inguinal
1463:Pyogenic
1408:Vascular
1184:Diarrhea
1162:Volvulus
1128:Vascular
1067: /
1056: /
1017:Ischemic
984:Appendix
874:Duodenum
744:Atrophic
618:Candidal
493:11191006
464:33251283
456:11355730
427:24341561
399:Pancreas
390:11189983
342:13064942
242:Ann Surg
190:Internal
171:Loss of
162:pancreas
156:External
86:external
78:pancreas
1775:Petit's
1751:Femoral
1654:Chronic
1468:Amoebic
1236:Anismus
1002:Colitis
929:Coeliac
906:Ileitis
878:Jejunum
731:Stomach
635:Rupture
544:D010185
419:2755944
307:1739176
263:1345487
177:fistula
136:amylase
103:ascites
1769:Lumbar
1739:Direct
1722:Hiatus
1702:Hernia
1554:Other
1320:Melena
1206:Rectum
689:(GERD)
491:
462:
454:
425:
417:
388:
369:
340:
305:
272:984927
270:
260:
120:pleura
72:is an
1694:Other
1649:Acute
1400:MASLD
1353:Liver
1327:Lower
1310:Upper
1152:Ileus
988:Colon
882:Ileum
697:(LPR)
533:577.8
460:S2CID
423:S2CID
151:Types
84:. An
1082:SCAD
539:MeSH
528:9-CM
489:PMID
452:PMID
415:PMID
386:PMID
367:ISBN
338:PMID
303:PMID
268:PMID
143:and
1388:PBC
1115:IBD
1049:IBS
524:ICD
481:doi
444:doi
407:doi
330:doi
295:doi
291:163
258:PMC
250:doi
246:184
1862::
1552:/
1150::
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927::
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531::
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477:16
475:.
458:.
450:.
440:71
438:.
421:.
413:.
401:.
382:63
380:.
336:.
326:67
324:.
301:.
289:.
266:.
256:.
244:.
240:.
226:^
126:.
68:A
1588:/
1261:/
1080:/
1076:/
990:)
986:/
982:(
884:)
880:/
876:/
872:(
579:e
572:t
565:v
526:-
516:D
495:.
483::
466:.
446::
429:.
409::
403:4
392:.
344:.
332::
309:.
297::
274:.
252::
20:)
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