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| ==[[Pancreatic fistula overview|Overview]]== | | ==[[Pancreatic fistula overview|Overview]]== |
| A pancreatic fistula is an abnormal connection between the epithelialized surfaces of the pancreatic duct and adjacent or distant structures, organs or cavities.
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| Clinical criteria defined by the International Study Group for Pancreatic Fistula (ISGPF) is a measurable drain output containing pancreas-derived enzyme amylase which is greater than three times the upper limit of the normal serum level measured on or after postoperative day three.
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| A revised grading for pancreatic fistula was proposed by ISGPF, according to which pancreatic fistula is graded either into a new category which involve an asymptomatic leakage from the pancreas called biochemical leak (BL), or Grade B including patients who undergo surgical procedures such as percutaneous or endoscopic drainage or angiographic procedures in order to promote the healing of fistula and Grade C including patients with organ failure requiring reoperations and mortality as a result of complication from pancreatic fistula.
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| ==[[Pancreatic fistula historical perspective|Historical Perspective]]== | | ==[[Pancreatic fistula historical perspective|Historical Perspective]]== |
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| ==[[Pancreatic fistula classification|Classification]]== | | ==[[Pancreatic fistula classification|Classification]]== |
| Pancreatic fistula can be classified anatomically as;
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| * Internal fistula: The pancreatic duct communicates with internal organs or body cavity such as pleural or peritoneal cavity.
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| * External fistula: The pancreatic duct communicates with the skin, otherwise known as pancreaticocutaneous fistula.
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| Pancreatic fistula can also be classified based on the anatomy of the pancreatic duct and the location of injury as;
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| * Type 1 pancreatic fistula: Involves injury to the pancreatic parenchyma with leakage from the distal part of the pancreatic duct or the side branches.
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| * Type 2 pancreatic fistula: Involves injury to and leak from the main pancreatic duct.
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| * Type 3 pancreatic fistula: Occurs as a result of proximal or distal pancreatectomy.
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| Pancreatic fistula is classified into two categories on the basis of clinical manifestations, complications and severity by the ISGPF as;
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| * Biochemical pancreatic fistula: This category includes fistula with no significant clinical symptoms.
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| * Clinically relevant pancreatic fistula: This category includes fistulas under grade B and C, which shows significant clinical symptoms and require surgical interventions, re-surgeries and can complicate into organ failure and death.
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| ==[[Pancreatic fistula pathophysiology|Pathophysiology]]== | | ==[[Pancreatic fistula pathophysiology|Pathophysiology]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Pancreatic fistula history and symptoms| History and Symptoms]] | [[Pancreatic fistula physical examination | Physical Examination]] | [[Pancreatic fistula laboratory findings|Laboratory Findings]] | [[Pancreatic fistula chest x ray|Chest X Ray]] | [[Pancreatic fistula CT|CT]] | [[Pancreatic fistula MRI|MRI]] | [[Pancreatic fistula ERCP|ERCP]] | [[Pancreatic fistula ultrasound|Ultrasound]] | [[Pancreatic fistula other imaging findings|Other Imaging Findings]] | [[Pancreatic fistula other diagnostic studies|Other Diagnostic Studies]]
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| | ===History and clinical presentation:=== |
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| | ===Imaging:=== |
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| | ===Laboratory tests:=== |
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| ==Treatment== | | ==Treatment== |
| [[Pancreatic fistula medical therapy|Medical Therapy]] | [[Pancreatic fistula surgery|Surgery]] | [[Pancreatic fistula primary prevention|Primary Prevention]] | [[Pancreatic fistula secondary prevention|Secondary Prevention]] | [[Pancreatic fistula cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Pancreatic fistula future or investigational therapies|Future or Investigational Therapies]]
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| ==Case Studies==
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| [[Pancreatic fistula case study one|Case #1]]
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| [[Category:Organ disorders]] | | [[Category:Organ disorders]] |
| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
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| {{WikiDoc Help Menu}}
| | ==References== |
| {{WikiDoc Sources}} | | {{reflist|2}} |
| <references />
| | [[category:Gastroenterology]] |