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Abstract pancreatic duct leaks can occur as a result of both acute and chronic pancreatitis or in the setting of pancreatic trauma Less commonly, they are the consequence of penetrating abdominal trauma. Manifestations of leaks include pseudocysts, pancreatic ascites, high amylase pleural effusions, disconnected duct syndrome, and internal and external pancreatic fistulas.
The treatment of people with clinically significant postoperative pancreatic leaks is different from those without clinically significant pancreatic leaks 3,7 external leaks (pancreaticocutaneous fistulas) almost always follow percutaneous drainage of internal pancreatic fluid collections or pancreatic surgery It is important to know the diagnostic accuracy of drain fluid amylase as a triage test for.
A pancreatic fistula can develop after any surgery that involves the pancreas, including a pancreaticoduodenectomy (whipple procedure) or a distal pancreatectomy
The risk of developing a pancreatic fistula after surgery is typically higher if the pancreas was affected by a tumor or inflammation prior to surgery. Pancreatic leak/fistula pancreatic leak/fistula definitions leak Pancreatic fluid leak due to duct disruption fistula Abnormal connection from pancreas to other structures/spaces internal
Duct communicates with peritoneal cavity, pleural cavity or hollow viscus external Duct communicates with skin output < 200 cc/day high output > 200 cc/day international study.
Monica saumoy introduction pancreatic duct (pd) leaks can occur in the setting of acute or chronic pancreatitis, trauma, or pancreatic resection
Their clinical manifestations vary widely depending on the underlying etiology and the site and extent of pd disruption Sequelae of pd leaks include peripancreatic and pancreatic fluid collections (pfcs), as well as internal and external pancreatic. When pancreatic juices leak, the digestive enzymes can irritate the surrounding tissues, forming a protective capsule around the leak Ascites simply denote a leak of pancreatic juice into the peritoneal cavity, while a pseudocyst occurs when the body walls off that pancreatic leak.
A pancreatic fistula is an abnormal communication between the pancreas and other organs due to leakage of pancreatic secretions from damaged pancreatic ducts An external 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 The causes of pancreatic duct disruption include acute pancreatitis, chronic pancreatitis, surgery, and trauma Persistent disruption can result in fluid collections, ascites, or fistulas and has a significant impact on the clinical course
Pancreatic leaks occur when a disruption in the pancreatic ductal system results in the leakage of pancreatic enzymes such as amylase, lipase, and proteases into the abdominal cavity
While often associated with pancreatic surgical procedures, trauma and necrotizing pancreatitis are also common culprits Pancreatic duct leaks or fistulas have traditionally been defined as internal or external
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