Sonographic demonstration of a pancreatopleural fistula

Pancreatopleural fistula is an uncommon complication of pancreatitis. The presence of a fistulous tract, although not mandatory for diagnosis of pancreatopleural fistula, has been documented previously with contrast-enhanced radiography and endoscopic retrograde cholangiopancreatography. We report the case of a pancreatopleural fistula with right pleural effusion demonstrated sonographically in a 13-year-old girl with a history of chronic pancreatitis and upper abdominal pain. Sonography also showed a pseudocyst of the pancreas with pleural effusion. The patient was treated conservatively with nutritional support and intercostal drainage of the pleural fluid. Her symptoms resolved and the pleural effusion gradually disappeared. Sonography is useful in confirming the presence of a suggested pancreatopleural fistula and can avoid the need for other, more technically challenging imaging modalities.