Year 2018 / Volume 110 / Number 10
Case Report
Enzymatic mediastinitis as a fearsome complication of pancreatic necrosectomy

669-671

DOI: 10.17235/reed.2018.5576/2018

Marta Paniagua García-Señoráns, María Reyes Meléndez Villar, Paula Senra del Río, Eva María García Fontán, Fabio Ausania,

Abstract
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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References
[1] Karakayali FY. Surgical and interventional management of complications caused by acute pancreatitis. World Journal of Gastroenterol. 2014 Oct 7;20(37):13412-23.
[2] Iacono C, Procacci C, Frigo F, et al. Thoracic complications of pacreatitis. Raven Press. Pancreas Vol. 4, No. 2, pp 228- 236. September 6, 1988
[3] Choe IS, Kim YS, Lee TH, et al. Acute mediastinitis arising from pancreatic mediastinal fistula in recurrent pancreatitis. World Journal of Gastroenterol. 2014 Oct 28;20(40):14997-5000.
[4] Ayuso Velasco R, García Barajas S, García- Sáez M. Mediastinitis secundaria a una pancreatitis aguda. Archivos de bronconeumología 2011; 47(6): 318-321.
[5] D. Stimac, M. Niksic, B. Sincic, et al. Mediastinal necrosis in acute pancreatitis- case report. Zentralbl Chir; 132(2): 155-7, 2007 Apr. doi: 10.1055/s-2007-960660
[6] Valverde A, Hammel P, Zins M, et al. Intracervical and mediastinal extension of a pancreatic collection in a patient with acute pancreatitis [Diffusion mediastinale et cervicale d'une coulee de necrose au cours d'une pancreatite aigue] (1999) Gastroenterologie Clinique et Biologique, 23 (1), pp. 137-140
[7] Krüger M, Decker S, Schneider JP, et al. Surgical treatment of acute mediastinitis. Chirurg. 2016 Jun;87(6):478-85
[8] Lee SN, Lee, KH, Chung S, et al. Pancreaticothoracic fistula presenting with hemoptysis and pneumothorax in a chronic alcoholic patient (2014) Tuberculosis and Respiratory Diseases, 76 (5), pp. 240-244 doi: 10.4046/trd.2014.76.5.240
[9] Chong BK, Yun JK, Kim JB, et al. Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis. Korean J Thorac Cardiovasc Surg. 2016 Oct;49(5):401-404
[10] Nullmeier S, Kuhn R, Lippert H, et al. Ascending pancreatitis with mediastinal and parapharyngeal involvement [Aszendierende Pankreatitis mit mediastinaler und parapharyngealer Beteiligung] (2009) HNO, 57 (9), pp. 965-968 doi: 10.1007/s00106-009-1979-z
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Paniagua García-Señoráns M, Meléndez Villar M, Senra del Río P, García Fontán E, Ausania F. Enzymatic mediastinitis as a fearsome complication of pancreatic necrosectomy. 5576/2018


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Publication history

Received: 05/03/2018

Accepted: 30/05/2018

Online First: 22/06/2018

Published: 01/10/2018

Article revision time: 83 days

Article Online First time: 109 days

Article editing time: 210 days


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