High amylase pleural effusion remains an entity which includes a wide variety of differentials, with pancreatitis, oesophageal rupture or malignant pleural effusion being most commonly encountered in clinical practice. Keeping the clinical picture (suggestive of pain in abdomen preceding any respiratory complaints) and differentials at hand, the case was evaluated with contrast-enhanced CT of the thorax and abdomen which revealed normal pancreatic architecture and no abnormal communication was noted between the pancreas and pleural space. A contrast oesophagogram, done when pancreatitis was ruled out, showed no evidence of any leak. The patient underwent upper gastrointestinal endoscopy which was suggestive of an ulcer with fistulous communication with the pleural space. Following nasojejunal feeding and clipping of the fistulous tract the patient’s symptoms improved.
- Pleural infection
- Respiratory medicine
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.