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CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2021; 04(01): 074-076
DOI: 10.1055/s-0040-1719222
Case Report

Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis

Ayah Megahed
1   Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
,
Rahul Hegde
1   Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
,
Pranav Sharma
1   Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
,
Rahmat Ali
1   Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
,
Anas Bamashmos
1   Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, United States
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Abstract

Pancreaticopleural fistula is a rare complication of chronic pancreatitis caused by disruption of the pancreatic duct and fistulous communication with the pleural cavity. It usually presents with respiratory symptoms from recurrent large volume pleural effusions. Paucity of abdominal symptoms makes it a diagnostic challenge, leading often to delayed diagnosis. Marked elevation of pleural fluid amylase, which is not a commonly performed test, is a sensitive marker in its detection. Imaging with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography can help delineate the fistula. In this report, we present the clinical features, imaging, and management of a 59-year-old male patient with pancreaticopleural fistula, wherein the diagnosis was suspected only after repeated pleural fluid drainages were performed for re-accumulating pleural effusions and it was eventually successfully treated with pancreatic duct stenting. We review the literature with regards to the incidence, presentation, diagnosis, and management of this rare entity.

Keywords

pancreatitis - chronic pancreatitis - pancreaticopleural fistula - recurrent pleural effusion - MRCP


Publikationsverlauf

Artikel online veröffentlicht:
13. Januar 2021

© 2021. Indian Society of Gastrointestinal and Abdominal Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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