Pancreatic pleuropericardial effusions. Fistulous tracts demonstrated by computed tomography

Abstract

Demonstration of the fistulous tract linking pancreatic pseudocysts to the mediastinum and pleural cavity has diagnostic and therapeutic implications. In four cases, pseudocyst drainage through the esophageal and aortic diaphragmatic crus into the mediastinum and pleural cavity was delineated by computed tomography. In two cases, significant pericardial effusions were demonstrated. Computed tomography offers an effective diagnostic method when treatment is dependent on anatomic localization of the disrupted pseudocyst and its intrathoracic drainage tract.

An Unusual Cause of Persistent Pleural Effusion in a Patient With Chronic Pancreatitis

“…(1) In pancreaticopleural fistula due to pancreatitis, large pleural fluid accumulates due to transdiaphragmatic fistulous tracts which allows a communication between the pseudocyst/peripancreatic collection and the pleural cavity. (6) The pleuro-pulmonary complications associated with pancreatitis are atelectasis, pneumonitis, adult respiratory distress syndrome and pancreatico-bronchial fistula. Small reactionary pleural effusions develop in 3-17% of patients with acute pancreatitis.…”