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Rare disease
Case report
Pancreaticopleural fistula: an uncommon cause of amylase-rich pleural effusion
  1. Valeri Kraskovsky1,
  2. Brianne Mackenzie2 and
  3. Martin Jeffery Mador3,4
  1. 1Pulmonary and Critical Care Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  2. 2Biomedical Informatics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  3. 3Pulmonary, Critical Care and Sleep Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  4. 4VA Western New York Healthcare System, Buffalo VA Medical Center, Buffalo, New York, USA
  1. Correspondence to Dr Valeri Kraskovsky; valerikr{at}buffalo.edu

Abstract

Pancreaticopleural fistula (PPF) causing pleural effusion as a complication of chronic pancreatitis is a rare finding. We present this finding in a 52-year-old man with a medical history significant for alcohol abuse, acute on chronic pancreatitis and severe chronic obstructive pulmonary disease, who presented with worsening dyspnoea for 3 days. CT scan of the chest showed a new large right-sided pleural effusion. Thoracentesis was performed and pleural fluid analysis showed an amylase-rich, exudative pleural effusion. The effusion reaccumulated within 3 days necessitating repeat thoracentesis. Endoscopic retrograde chloangiopancreatography showed contrast leak through a single disruption in the dorsal pancreatic duct, suspicious for an underlying PPF. The patient underwent stenting of the pancreatic duct with subsequent resolution of right-sided pleural effusion.

  • pancreatitis
  • respiratory medicine
  • radiology

https://doi.org/10.1136/bcr-2020-236232

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    Footnotes

    • Contributors VK, BM and MJM contributed to the writing and editing of the manuscript.

    • 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 for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.