RT Journal Article
SR Electronic
T1 Pancreaticopleural fistula: an uncommon cause of amylase-rich pleural effusion
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e236232
DO 10.1136/bcr-2020-236232
VO 13
IS 8
A1 Valeri Kraskovsky
A1 Brianne Mackenzie
A1 Martin Jeffery Mador
YR 2020
UL http://casereports.bmj.com/content/13/8/e236232.abstract
AB 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.