Rare case of internal pancreatic fistula in a young adult presenting with massive bilateral pleural effusion

Abstract

Pancreatic pleural fistula is a rare sequel of acute or chronic pancreatitis. The diagnosis is usually delayed due to low index of suspicion and the need for advanced diagnostic tools. The clinical presentation is often misleading because respiratory rather than abdominal symptoms predominate. The majority of reported cases of pancreatic pleural fistula present as unilateral pleural effusion; presentation as bilateral pleural effusion is extremely rare. We report a case of a 16-year-old boy with traumatic acute pancreatitis who presented with a massive bilateral pleural effusion caused by pancreatico-pleural fistula.

MDCT in Diagnosis of Uncommon Fistulous Complications of Severe Pancreatitis-Pictorial Essay

“…The Radiologist must be aware of various clinical and radiological features of such uncommon complications which aid in faster diagnosis and optimize treatment. The advantage of CT is that it can noninvasively demonstrate pancreatic pathology and the fistulas in a single scan are useful when Endoscopic Retrograde Cholangiopancreatography (ERCP) does not provide adequate information [10].…”

Recurrent haemoptysis, left-sided chest pain and an evolving left lower lobe cavity in a 50-year old smoker with prior high ethanol intake

“…Abdominal symptoms occur in 29% cases 1. Chronic relapsing ethanol-related pancreatitis2 is the commonest cause (50%); others include biliary stone disease,2 endoscopic retrograde cholangiopancreaticography (ERCP),3 and traumatic pancreatitis 4. Diagnosis is suggested by grossly elevated pleural fluid amylase and confirmatory imaging.…”