Article Text
Summary
A 41-year-old man with a medical history of chronic back pain, seizure disorder, alcohol and tobacco abuse presented with acute shortness of breath. Chest X-ray showed a large right-sided pleural effusion. Pleural fluid analysis was significant for an elevated amylase level, suggestive of pleural effusion secondary to pancreatitis. Magnetic resonance cholangiopancreatography (MRCP) revealed a persistent right-sided pleural effusion in connection with a right pararenal space fluid collection via a Bochdalek hernia. An endoscopic ultrasound found hyperechoic strands and foci, and pancreatic parenchyma consistent with chronic pancreatitis, as well as a pseudocyst in the pancreatic head. A chest tube was ultimately placed to continuously drain the pleural effusion. The patient was discharged and was referred to gastroenterology for outpatient follow-up. This case illustrates a rare presentation of chronic pancreatitis with a Bochdalek hernia as a right-sided pleural effusion in a patient who was previously asymptomatic.
- GI-stents
- pancreas and biliary tract
- pancreatitis
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Footnotes
Contributors H-MY contributed to the writing, editing, formatting of the main manuscript and production of the figures. EK and SS contributed to the writing, editing and formatting of the main manuscript. XD conceived the project and supervised the production of the manuscript. XD, H-MY, EK, SS certify that all authors have contributed and met criteria for authorship defined by BMJ.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.