Summary

Pancreatic pleural fistula is a rare sequel of acute or chronic pancreatitis. The diagnosis is usually delayed due to low index of suspicion and the need for advanced diagnostic tools. The clinical presentation is often misleading because respiratory rather than abdominal symptoms predominate. The majority of reported cases of pancreatic pleural fistula present as unilateral pleural effusion; presentation as bilateral pleural effusion is extremely rare. We report a case of a 16-year-old boy with traumatic acute pancreatitis who presented with a massive bilateral pleural effusion caused by pancreatico-pleural fistula.