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Review
. 2024 Mar 29;18(1):131.
doi: 10.1186/s13256-024-04457-8.

Pancreaticopleural fistula causing pleural effusion: a case report and review of the literature

Milan Khadka  1 , Suzit Bhusal  2 , Binod Pantha  1 , Rabin Gautam  1 , Kapil Gautam  1 , Ashlesha Chaudhary  3
Affiliations
Review

Pancreaticopleural fistula causing pleural effusion: a case report and review of the literature

Milan Khadka et al. J Med Case Rep. .

Abstract

Background: Pancreaticopleural fistula is a rare complication of pancreatitis and poses diagnostic and therapeutic challenges. This case report sheds light on the unique challenges posed by pancreaticopleural fistula as a rare complication of pancreatitis. The aim is to contribute valuable insights to the scientific literature by presenting a case involving a middle-aged man with acute necrotizing pancreatitis and associated pleural effusion.

Case presentation: A 41-year-old Asian male with a history of pancreatitis and chronic alcohol use presented with severe dyspnea, chest pain, and left-sided pleural effusion. Elevated serum amylase lipase levels and imaging confirmed acute necrotizing pancreatitis with a computed tomography severity index of 8/10. Magnetic resonance cholangiopancreatography revealed pancreatic necrosis and pseudocyst formation and findings suggestive of pancreaticopleural fistula. The patient was then treated with octreotide therapy.

Conclusion: The management of pancreaticopleural fistula demands a comprehensive and individualized approach. Recognition guided by high clinical suspicion coupled with appropriate investigations and a careful balance between medical, endoscopic, and surgical interventions is crucial for achieving favorable outcomes. This case report adds to the scientific literature by providing insights into the complexities of pancreaticopleural fistula and emphasizing the importance of personalized strategies in its management.

Keywords: Acute necrotizing pancreatitis; Case report; Octreotide therapy; Pancreaticopleural fistula; Pleural effusion.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Computed tomography scan showing gross free fluid in the left pleural cavities
Fig. 2
Fig. 2
Magnetic resonance cholangiopancreatography images demonstrating heterogeneous signal of the pancreas, ill-defined margins, and fluid surrounding the pancreas
Fig. 3
Fig. 3
Dark-red pleural fluid from the patient’s left pleural cavity
See this image and copyright information in PMC

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