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Massive Bilateral Hemorrhagic Pleural Effusions in Chronic Relapsing Pancreatitis

Massive Bilateral Hemorrhagic Pleural Effusions in Chronic Relapsing Pancreatitis Abstract Bizarre pulmonary signs and symptoms may occur in association with pancreatitis. The frequency of pulmonary changes is estimated to be 14% to 17%.1-4 Pleural effusions were first described in acute pancreatitis and more recently in chronic pancreatitis as well.5-7 In the collective data from three large series of pancreatitis cases in the literature (518 patients), the frequency of pleural effusions was 5.2%, (27 patients).1,3,4 Pleural effusions occurred on the left side in 18 patients and were bilateral in seven patients. Eight detailed descriptions of bilateral pleural effusions associated with pancreatitis have been recorded, a total of 15 cases.7-12 In the patient to be described, chronic relapsing pancreatitis was associated with bilateral bloody pleural effusions. There have been two previous case reports of bilateral hemorrhagic pleural effusions in patients with pancreatitis.7-11 Report of a Case A 52-year-old chronic alcoholic was admitted to the Manhattan Veterans Administration References 1. Fishbein, R.; Murphy, G.P.; and Wilder, R.J.: The Pleuropulmonary Manifestations of Pancreatitis , Dis Chest 41:392-397 ( (April) ) 1962.Crossref 2. Lipp, W.E., and Aaron, A.H.: Acute Pancreatitis: Further Observations of Value in Its Recognition , New York State J Med 50:2043-2047 ( (Sept 1) ) 1950. 3. Roseman, D.J.; Kowlessar, O.D.; and Sleisenger, M.H.: Pulmonary Manifestations of Pancreatitis , New Eng J Med 263:294-296 ( (April 11) ) 1960.Crossref 4. Coffey, R.J.: Unusual Features of Pancreatic Disease , Ann Surg 135:715-720 ( (May) ) 1952.Crossref 5. Hulten, O.: Beitrage Zur Rontgendiagnose Der Akuten Pankreats-affektionen , Acta Radiol 9:222-254 ( (July 15) ) 1928.Crossref 6. De Takats, G.; and Mackenzie, W.P.: Acute Pancreatic Necrosis and Its Sequelae , Ann Surg 96:418-440 ( (Sept) ) 1932.Crossref 7. Werner, H.: Pankreatogene Pleuritis , Zentralbl fur Inn Med 67:577-585 ( (Aug 1) ) 1942. 8. Brouet, G.; Chrétien, J.; and Modai, J.: Les Pleurésies des Pancréatites Chroniques , J Franc Med Chir Thor 18:137-171 ( (Feb) -March) 1964. 9. Cachin, J.C., and Battesti, J.P.: Les Pleurésies Avec Elevation du Taux de l'Amylase Pleurale , Poumon et Coeur 20:378-387, 1964. 10. Cornet, E.; Dupon, H.; and Giraudet, J.: Pleuresies Hemorragiques d'Origine Pancréatique , Ann Chir Thor Cardiov 2:100-107 ( (Jan) ) 1963. 11. Mitchell, E.E.: Relapsing Pancreatitis With Recurrent Pericardial and Pleural Effusions , Ann Intern Med 60:1047-1053 ( (June) ) 1964.Crossref 12. Sarrazin, A., et al: Pleurésie et Syndrome Péritoneo-Pleurale Révelant une Affection Pancréatique Chronique , Bull Soc Méd Hôp Paris 116:209-216 ( (Oct) ) 1965. 13. Hammarstein, J.F.; Honska, W.L.; and Limes, B.J.: Pleural Fluid Amylase in Pancreatitis and Other Diseases , Amer Rev Tuberc 79:606-611 ( (May) ) 1959. 14. Bittar, E.E.: Amylase Activity in Hemothorax Associated with Pancreatitis , Arch Intern Med 109:601-602 ( (May) ) 1962.Crossref 15. Blumberg, L.; and Stein, L.: Traumatic Pancreatitis Complicated by Enzyme Containing Pleural Effusion , S Afr Med J 36:189-191 ( (March 10) ) 1962. 16. Kalser, M.H.; Roth, J.L.A.; and Bockus, J.L.: Relapsing Pancreatitis With Pseudocyst of the Pancreas and Enzyme Containing Pleural Effusion Gastroenterology 28:842-850 ( (May) ) 1955. 17. Moreaux, J., et al: Pancréatites et Epanchements , Ann Chir 20:413-423 ( (March) ) 1966. 18. Modai, J. and Chrétien, J.: Les Pleurésies des Pancréatites , Gaz. Med. Fr. 72:3853-3868 ( (Nov) ) 1965. 19. Modai, J.; Hazard, J. and Domart, A.: Epanchements Pleuropéritonéaux Revelateurs de Pancréatites Chroniques , Bull Soc Méd Hôp Paris 116:1217-1230 ( (Oct 15) ) 1965. 20. Warter, J.; Weill, J.P.; and Storck, D: Epanchement Péricardique d'Origine Pancréatique , Presse Méd 170:255-257 ( (Feb 3) ) 1962. 21. Goldman, J.G., and Fleschner, F.: Pleural Fluid Amylase in Acute Pancreatitis , New Eng J Med 266:715-716 ( (April 15) ) 1962.Crossref 22. Alivasatos, A.S.: Pancréas Polykystique Kystes Rompus dans l'Abdomen et Pénetration due Contenu dans la Plevre Droite , Bull Soc Med Hôp Paris 44:11811191, 1920. 23. Bergmann, F.; Jacobs, E.; Malaisse, W. and Thys, J.P.: Fistulation Pleurale d'un Pseudokyste Pancréatique , Acta Chir Belg 3 ( (suppl) ):128-135 (June 26) 1965. 24. Edin, P.: Mediastinal Pseudocyst of the Pancreas , Gastroenterology 17:96-102 ( (Jan) ) 1951. 25. Hess, W., and Rutte, B.: Die Intermittierende und Perforierende Pankreascyste , Schweiz Med Wschr 80:476-479 ( (May 6) ) 1950. 26. Clauss, R.H. and Wilson, M.D.: Pancreatic Pseudocyst of the Mediastinum , J Thorac Surg 35:795-801 ( (June) ) 1958. 27. McClintock, J.T.; McFee, J.L.; and Quimby, R.L.: Pancreatic Pseudocyst Presenting as a Mediastinal Tumor , JAMA 192:573-574 ( (May 10) ) 1965.Crossref 28. Gray, H.: Anatomy of the Human Body , ed. 26, C. M. Goss (ed.) Philadelphia: Lea & Febiger, Publishers 1954, pp 783-796. 29. Bartos, V., et al: Alterations in Human Thoracic Duct Lymph in Relation to Function of the Pancreas , Amer J Med Sci 252:31-38 ( (July) ) 1966.Crossref 30. Dumont, A.E.; Doubilet, H.; and Mulholland, J.L.: Lymphatic Pathway of Pancreatic Secretion in Man , Ann Surg 152:403-409 ( (Sept) ) 1960. 31. Bartos, V., et al: Thoracic Duct Lymph Amylase in Patients With Chronic Pancreatic Disease After Administration of Secretin , Amer J Med Sci 252:660-667 ( (Dec) ) 1966. 32. Blalock, A.S., et al: Experimental Studies in Lymphatic Blockage , Arch Surg 34:1049-1071 ( (June) ) 1937.Crossref 33. Bartholomew, L.G. and Comfort, M.W.: Chronic Pancreatitis Without Pain , Gastroenterology 31:727-745 ( (Dec) ) 1956. 34. Egdahl, R.H.: Mechanism of Blood Enzyme Changes Following the Production of Experimental Pancreatitis , Ann Surg 148:389-399 ( (Sept) ) 1958.Crossref 35. Popper, H.L.: Enzyme Studies in Edema of the Pancreas and Acute Pancreatitis , Surgery 7:566-573 ( (April) ) 1940. 36. Perry, T.T.: Role of Lymphatic Vessels in the Transmission of Lipase in Disseminated Pancreatic Fat Necrosis , Arch Path 43:456-465 ( (May) ) 1947. 37. Sarles, J.C.; Pietri, H.; and Sarles, H.; La Lymphographie dans la Pancréatite Chronique de l'Adulte , Presse Méd 73:2885-2888 ( (Nov) ) 1965. 38. Blumenthal, H.T. and Probstein, J.G.: Pancreatitis, a Clinical-Pathologic Correlation , Springfield, Ill: Charles C Thomas, Publisher 1959, p 224. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Massive Bilateral Hemorrhagic Pleural Effusions in Chronic Relapsing Pancreatitis

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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1969.01340070080014
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Abstract

Abstract Bizarre pulmonary signs and symptoms may occur in association with pancreatitis. The frequency of pulmonary changes is estimated to be 14% to 17%.1-4 Pleural effusions were first described in acute pancreatitis and more recently in chronic pancreatitis as well.5-7 In the collective data from three large series of pancreatitis cases in the literature (518 patients), the frequency of pleural effusions was 5.2%, (27 patients).1,3,4 Pleural effusions occurred on the left side in 18 patients and were bilateral in seven patients. Eight detailed descriptions of bilateral pleural effusions associated with pancreatitis have been recorded, a total of 15 cases.7-12 In the patient to be described, chronic relapsing pancreatitis was associated with bilateral bloody pleural effusions. There have been two previous case reports of bilateral hemorrhagic pleural effusions in patients with pancreatitis.7-11 Report of a Case A 52-year-old chronic alcoholic was admitted to the Manhattan Veterans Administration References 1. Fishbein, R.; Murphy, G.P.; and Wilder, R.J.: The Pleuropulmonary Manifestations of Pancreatitis , Dis Chest 41:392-397 ( (April) ) 1962.Crossref 2. Lipp, W.E., and Aaron, A.H.: Acute Pancreatitis: Further Observations of Value in Its Recognition , New York State J Med 50:2043-2047 ( (Sept 1) ) 1950. 3. Roseman, D.J.; Kowlessar, O.D.; and Sleisenger, M.H.: Pulmonary Manifestations of Pancreatitis , New Eng J Med 263:294-296 ( (April 11) ) 1960.Crossref 4. Coffey, R.J.: Unusual Features of Pancreatic Disease , Ann Surg 135:715-720 ( (May) ) 1952.Crossref 5. Hulten, O.: Beitrage Zur Rontgendiagnose Der Akuten Pankreats-affektionen , Acta Radiol 9:222-254 ( (July 15) ) 1928.Crossref 6. De Takats, G.; and Mackenzie, W.P.: Acute Pancreatic Necrosis and Its Sequelae , Ann Surg 96:418-440 ( (Sept) ) 1932.Crossref 7. Werner, H.: Pankreatogene Pleuritis , Zentralbl fur Inn Med 67:577-585 ( (Aug 1) ) 1942. 8. Brouet, G.; Chrétien, J.; and Modai, J.: Les Pleurésies des Pancréatites Chroniques , J Franc Med Chir Thor 18:137-171 ( (Feb) -March) 1964. 9. Cachin, J.C., and Battesti, J.P.: Les Pleurésies Avec Elevation du Taux de l'Amylase Pleurale , Poumon et Coeur 20:378-387, 1964. 10. Cornet, E.; Dupon, H.; and Giraudet, J.: Pleuresies Hemorragiques d'Origine Pancréatique , Ann Chir Thor Cardiov 2:100-107 ( (Jan) ) 1963. 11. Mitchell, E.E.: Relapsing Pancreatitis With Recurrent Pericardial and Pleural Effusions , Ann Intern Med 60:1047-1053 ( (June) ) 1964.Crossref 12. Sarrazin, A., et al: Pleurésie et Syndrome Péritoneo-Pleurale Révelant une Affection Pancréatique Chronique , Bull Soc Méd Hôp Paris 116:209-216 ( (Oct) ) 1965. 13. Hammarstein, J.F.; Honska, W.L.; and Limes, B.J.: Pleural Fluid Amylase in Pancreatitis and Other Diseases , Amer Rev Tuberc 79:606-611 ( (May) ) 1959. 14. Bittar, E.E.: Amylase Activity in Hemothorax Associated with Pancreatitis , Arch Intern Med 109:601-602 ( (May) ) 1962.Crossref 15. Blumberg, L.; and Stein, L.: Traumatic Pancreatitis Complicated by Enzyme Containing Pleural Effusion , S Afr Med J 36:189-191 ( (March 10) ) 1962. 16. Kalser, M.H.; Roth, J.L.A.; and Bockus, J.L.: Relapsing Pancreatitis With Pseudocyst of the Pancreas and Enzyme Containing Pleural Effusion Gastroenterology 28:842-850 ( (May) ) 1955. 17. Moreaux, J., et al: Pancréatites et Epanchements , Ann Chir 20:413-423 ( (March) ) 1966. 18. Modai, J. and Chrétien, J.: Les Pleurésies des Pancréatites , Gaz. Med. Fr. 72:3853-3868 ( (Nov) ) 1965. 19. Modai, J.; Hazard, J. and Domart, A.: Epanchements Pleuropéritonéaux Revelateurs de Pancréatites Chroniques , Bull Soc Méd Hôp Paris 116:1217-1230 ( (Oct 15) ) 1965. 20. Warter, J.; Weill, J.P.; and Storck, D: Epanchement Péricardique d'Origine Pancréatique , Presse Méd 170:255-257 ( (Feb 3) ) 1962. 21. Goldman, J.G., and Fleschner, F.: Pleural Fluid Amylase in Acute Pancreatitis , New Eng J Med 266:715-716 ( (April 15) ) 1962.Crossref 22. Alivasatos, A.S.: Pancréas Polykystique Kystes Rompus dans l'Abdomen et Pénetration due Contenu dans la Plevre Droite , Bull Soc Med Hôp Paris 44:11811191, 1920. 23. Bergmann, F.; Jacobs, E.; Malaisse, W. and Thys, J.P.: Fistulation Pleurale d'un Pseudokyste Pancréatique , Acta Chir Belg 3 ( (suppl) ):128-135 (June 26) 1965. 24. Edin, P.: Mediastinal Pseudocyst of the Pancreas , Gastroenterology 17:96-102 ( (Jan) ) 1951. 25. Hess, W., and Rutte, B.: Die Intermittierende und Perforierende Pankreascyste , Schweiz Med Wschr 80:476-479 ( (May 6) ) 1950. 26. Clauss, R.H. and Wilson, M.D.: Pancreatic Pseudocyst of the Mediastinum , J Thorac Surg 35:795-801 ( (June) ) 1958. 27. McClintock, J.T.; McFee, J.L.; and Quimby, R.L.: Pancreatic Pseudocyst Presenting as a Mediastinal Tumor , JAMA 192:573-574 ( (May 10) ) 1965.Crossref 28. Gray, H.: Anatomy of the Human Body , ed. 26, C. M. Goss (ed.) Philadelphia: Lea & Febiger, Publishers 1954, pp 783-796. 29. Bartos, V., et al: Alterations in Human Thoracic Duct Lymph in Relation to Function of the Pancreas , Amer J Med Sci 252:31-38 ( (July) ) 1966.Crossref 30. Dumont, A.E.; Doubilet, H.; and Mulholland, J.L.: Lymphatic Pathway of Pancreatic Secretion in Man , Ann Surg 152:403-409 ( (Sept) ) 1960. 31. Bartos, V., et al: Thoracic Duct Lymph Amylase in Patients With Chronic Pancreatic Disease After Administration of Secretin , Amer J Med Sci 252:660-667 ( (Dec) ) 1966. 32. Blalock, A.S., et al: Experimental Studies in Lymphatic Blockage , Arch Surg 34:1049-1071 ( (June) ) 1937.Crossref 33. Bartholomew, L.G. and Comfort, M.W.: Chronic Pancreatitis Without Pain , Gastroenterology 31:727-745 ( (Dec) ) 1956. 34. Egdahl, R.H.: Mechanism of Blood Enzyme Changes Following the Production of Experimental Pancreatitis , Ann Surg 148:389-399 ( (Sept) ) 1958.Crossref 35. Popper, H.L.: Enzyme Studies in Edema of the Pancreas and Acute Pancreatitis , Surgery 7:566-573 ( (April) ) 1940. 36. Perry, T.T.: Role of Lymphatic Vessels in the Transmission of Lipase in Disseminated Pancreatic Fat Necrosis , Arch Path 43:456-465 ( (May) ) 1947. 37. Sarles, J.C.; Pietri, H.; and Sarles, H.; La Lymphographie dans la Pancréatite Chronique de l'Adulte , Presse Méd 73:2885-2888 ( (Nov) ) 1965. 38. Blumenthal, H.T. and Probstein, J.G.: Pancreatitis, a Clinical-Pathologic Correlation , Springfield, Ill: Charles C Thomas, Publisher 1959, p 224.

Journal

Archives of Surgery – American Medical Association

Published: Jan 1, 1969

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