A bronchopancreatic fistula developed in a 14-year-old boy two weeks following transabdominal splenectomy and repair of a ruptured diaphragm. This unusual entity should be suspected when a patient with pancreatitis or pancreatic trauma has pleural complications associated with profuse, frothy sputum. The diagnosis is established by the presence of high levels of amylase in the sputum or by the appearance in the sputum or the bronchi of dye or contrast material injected into the external fistula. The primary goal of treatment, in addition to the management of the thoracic complications, is subdiaphragmatic control of the pancreatic fistula. A brief summary of seven previously reported cases is presented.
(JAMA 237:1461-1463, 1977)
Cox CL, Anderson JN, Guest JL. Bronchopancreatic Fistula Following Traumatic Rupture of the Diaphragm. JAMA. 1977;237(14):1461-1463. doi:10.1001/jama.1977.03270410061024