A 48-year-old man, who was a heavy drinker, presented to our hospital with dyspnea that had persisted for two weeks. A chest radiograph (Picture 1) and computed tomography scans revealed right massive pleural effusion and mediastinal pseudocysts (Picture 2: red arrow) extending from the tail of the pancreas (Picture 3: blue arrow, pancreatic pseudocysts; yellow arrow, pancreas). The pleural fluid aspirated was dark brown with a high amylase content (2,982 IU/L). After drainage of the right pleural effusion, he was treated by surgical resection and internal drainage. He was discharged three weeks after surgery and has shown no recurrence. Pancreaticopleural fistula, leading to the formation of mediastinal pseudocysts, is a rare complication of pancreatitis and results from the disruption of the main pancreatic duct and tracking of pancreatic fluid through the retroperitoneum into the mediastinum via the aortic or esophageal hiatus (1,2). Pancreaticopleural fistula should be included in the differential diagnosis of massive pleural effusion.
Picture 1.
Picture 2.
Picture 3.
The authors state that they have no Conflict of Interest (COI).
References
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