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Significance of pleural effusion in patients with acute pancreatitis
1Department of Medicine, Mount Sinai Services-City Hospital Center, Elmhurst, New York.
Insights
Pleural effusion in acute pancreatitis is linked to alcoholic causes and severe disease. Most effusions resolved spontaneously, and hypertriglyceridemia was not a significant factor.
Area of Science:
- Gastroenterology
- Pulmonology
- Internal Medicine
Background:
- Pleural effusion is a known complication of acute pancreatitis.
- The specific associations between pleural effusion and various factors in acute pancreatitis require further elucidation.
Purpose of the Study:
- To investigate the relationship between pleural effusion and the severity, etiology, pseudocyst formation, and triglyceride levels in patients with acute pancreatitis.
Main Methods:
- Retrospective chart review of 82 patients with acute pancreatitis admitted between July 1987 and June 1991.
- Analysis of patient data to identify the presence of pleural effusion and correlate it with clinical factors.
Main Results:
- Eleven (13.4%) patients developed pleural effusion.
- Alcoholic pancreatitis (8/42) was more frequently associated with effusion than biliary pancreatitis (1/33).
- Severe pancreatitis and pseudocyst formation were linked to a higher incidence of pleural effusion.
Conclusions:
- Alcoholic etiology and disease severity are risk factors for pleural effusion in acute pancreatitis.
- Pseudocyst formation is associated with pleural effusion.
- Hypertriglyceridemia is not an independent risk factor for pleural effusion in this patient cohort.
Abstract:
We retrospectively reviewed the charts of all patients with acute pancreatitis admitted to our hospital between July 1987 and June 1991 to determine the relationship of a pleural effusion in patients with acute pancreatitis with the severity of the disease, the etiology of the pancreatitis, pseudocyst formation, and triglyceride levels. Eleven (13.4%) of the 82 patients with acute pancreatitis had evidence of pleural effusion. Eight of 42 patients with alcoholic pancreatitis developed an effusion, compared with one of 33 patients with biliary pancreatitis, indicating that an alcoholic etiology may be a risk factor. Seven (63%) of the 11 patients had associated pseudocysts. Patients with severe disease had a greater incidence of pleural effusion. The effusion was on the left side in six, bilateral in four, and on the right side in one patient. Hypertriglyceridemia did not appear to be an independent risk factor associated with pleural effusions. Diagnostic thoracentesis was performed in three patients because of the presence of fever. Pleural fluid amylase was normal in one case and mildly elevated in the other two. All effusions resolved spontaneously without the need for any therapeutic intervention.