Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Emergency Medicine
Volume 2016, Article ID 4269424, 3 pages
http://dx.doi.org/10.1155/2016/4269424
Case Report

Pancreatic Pseudocyst Pleural Fistula in Gallstone Pancreatitis

Department of General Surgery, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK

Received 30 December 2015; Accepted 19 April 2016

Academic Editor: Serdar Kula

Copyright © 2016 Sala Abdalla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancreatitis. The diagnosis is often delayed given that the majority of patients present with pulmonary symptoms and frequently have large, persistent pleural effusions. The diagnosis is confirmed through imaging and the detection of significantly elevated amylase levels in the pleural exudate. Treatment options include somatostatin analogues, thoracocentesis, endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic duct stenting, and surgery. The authors present a case of pancreatic pseudocyst pleural fistula in a woman with gallstone pancreatitis presenting with recurrent pneumonias and bilateral pleural effusions.