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EN
We are reporting a case of a pancreatic-pleural fistula causing epigastric pain. Chest radiograph revealed pleural effusion reaching the seventh rib. Thoracocentesis was performed and 1600 mL of brownish fluid was removed, which showed an elevated amylase level. Ultimately, the diagnosis was confirmed by computed tomography. Due to the failure of medical and endoscopic treatment, the decision was made to perform surgery. It resulted in total pancreatectomy.
PL
Przedstawiamy przypadek przetoki trzustkowo-opłucnowej objawiającej się dolegliwościami bólowymi nadbrzusza. Na zdjęciach RTG klatki piersiowej uwidoczniono płyn w prawej jamie opłucnowej, sięgający do VII żebra. Po punkcji opłucnej uzyskano 1600 ml brunatnego płynu z wysokim poziomem diastaz. Ostateczne rozpoznanie postawiono na podstawie tomografii komputerowej. Ze względu na niepowodzenie metod zachowawczych i endoskopowych, zdecydowano się na zabieg operacyjny, który zakończył się totalną resekcją trzustki.
EN
Background: Negative Pressure Wound Therapy (NPWT) is used in the treatment of various wounds. The study demonstrates a novel use of vessel patch as a sealant of mucosal orifice fistulas. Methods: The study included ten patients with orocutaneous fistulas in the course of treatment of oral malignancies. Patients were divided into treatment (NPWT) and control (conventional dressings) group. In four cases, the vessel patch was applied. We used the Hartmann Vivano system with 50 mmHg to 130 mmHg negative pressure values. Results: The median age of patients was 61.5 years (range: 31 -- 73 years). The median treatment time was 83 days (range: 14 -- 272 days). The median total treatment cost was 5.300 EUR (range: 2490 -- 7821 EUR) in the NPWT group and 12.000 EUR (range: 3.060 -- 22.745 EUR) in the control group. Conclusion: The use of NPWT is a cost-effective and reasonable method for the management of orocutaneous fistulas and other complications in maxillofacial surgery.
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