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

• Published in: Journal of medical case reports Vol. 18; no. 1; p. 131
• Main Authors: Khadka, Milan, Bhusal, Suzit, Pantha, Binod, Gautam, Rabin, Gautam, Kapil, Chaudhary, Ashlesha
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.03.2024; BioMed Central; BMC
• Subjects: Acute necrotizing pancreatitis; Adult; Alcohol; Amylases; Case report; Case reports; Cholangiopancreatography, Endoscopic Retrograde; CT imaging; Cysts; Diagnosis; Dyspnea; Endoscopy; Fistula; Health aspects; Homeopathy; Humans; Male; Males; Materia medica and therapeutics; Middle age; Middle Aged; Octreotide therapy; Pancreatic Fistula - complications; Pancreatic Fistula - diagnostic imaging; Pancreaticopleural fistula; Pancreatitis; Pancreatitis, Acute Necrotizing - complications; Pleural Diseases - complications; Pleural Diseases - diagnostic imaging; Pleural effusion; Pleural Effusion - diagnostic imaging; Pleural Effusion - etiology; Pleural Effusion - therapy; Pleural effusions; Respiratory Tract Fistula - diagnostic imaging; Respiratory Tract Fistula - etiology; Therapeutics; Tomography; Acute necrotizing pancreatitis; Pleural effusion; Case report; Pancreaticopleural fistula; Octreotide therapy
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-024-04457-8

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. 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. 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.