Pancreatic fistula pathophysiology: Difference between revisions
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**Metabolic acidosis (Due to loss of bicarbonate) | **Metabolic acidosis (Due to loss of bicarbonate) | ||
**Malnutrition (Due to malabsorption of fats) | **Malnutrition (Due to malabsorption of fats) | ||
*Based on the anatomical location of the pancreatic fistulas it will result in the following complications: | *Based on the anatomical location of the pancreatic fistulas it will result in the following complications:<ref name="pmid11355730">{{cite journal| author=Kaman L, Behera A, Singh R, Katariya RN| title=Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management. | journal=ANZ J Surg | year= 2001 | volume= 71 | issue= 4 | pages= 221-5 | pmid=11355730 | doi=10.1046/j.1440-1622.2001.02077.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11355730 }}</ref> | ||
**Anterior pancreatic fistula results in pancreatic ascites. | **Anterior pancreatic fistula results in pancreatic ascites. | ||
**Posterior pancreatic fistula results in pleural effusions or mediastinitis. | **Posterior pancreatic fistula results in pleural effusions or mediastinitis. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The disruption of the pancreatic duct either from an iatrogenic insult, underlying inflammatory process or trauma results in the leakage of the pancreatic fluid inducing inflammation and erosions, thereby forming abnormal connections with the surrounding structures.
Pathophysiology
- The pathophysiology of pancreatic fistula involves the disruption of the pancreatic duct either from an iatrogenic insult, underlying inflammatory process or trauma.
- The disruption of the pancreatic duct causes gradual loss of the integrity of the tissue resulting in the leakage of the pancreatic fluid which induces inflammation and erosions, thereby leading to the formation of abnormal connections between the duct and the surrounding structures.[1][2]
- Pseudocyst is a complication of pancreatic fistula when fibroinflammatory rind is formed due to fluid collections and the leak which s caused by pancreatic fistula.
- Pancreatic secretions are rich in bicarbonate and protein, in some cases where the fistulas are big in size it might lead to the following conditions:
- Dehydration
- Metabolic acidosis (Due to loss of bicarbonate)
- Malnutrition (Due to malabsorption of fats)
- Based on the anatomical location of the pancreatic fistulas it will result in the following complications:[3]
- Anterior pancreatic fistula results in pancreatic ascites.
- Posterior pancreatic fistula results in pleural effusions or mediastinitis.
References
- ↑ Nahm CB, Connor SJ, Samra JS, Mittal A (2018). "Postoperative pancreatic fistula: a review of traditional and emerging concepts". Clin Exp Gastroenterol. 11: 105–118. doi:10.2147/CEG.S120217. PMC 5858541. PMID 29588609.
- ↑ Hackert T, Werner J, Büchler MW (2011). "Postoperative pancreatic fistula". Surgeon. 9 (4): 211–7. doi:10.1016/j.surge.2010.10.011. PMID 21672661.
- ↑ Kaman L, Behera A, Singh R, Katariya RN (2001). "Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management". ANZ J Surg. 71 (4): 221–5. doi:10.1046/j.1440-1622.2001.02077.x. PMID 11355730.