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Pancreaticopleural Fistula: A Rare Presentation and a Rare Complication

Ahmad Ramahi1, Kanana Mohammad Aburayyan1, Tamer S Said Ahmed2

  • 1Internal Medicine, University of Toledo Medical Center, Toledo, USA.

Cureus
|September 11, 2019
PubMed

Insights

Pancreaticopleural fistula, a rare pancreatitis complication, often presents with lung symptoms. Diagnosis involves finding amylase in pleural fluid, confirming the pancreatic fistula.

Area of Science:

  • Gastroenterology and Pulmonology
  • Medical Imaging
  • Diagnostic Biomarkers

Background:

  • Pancreaticopleural fistula (PPF) is an uncommon but serious complication of pancreatitis.
  • Patients frequently exhibit pulmonary symptoms, masking the underlying pancreatic etiology.
  • Early recognition is crucial for effective management.

Observation:

  • A case of massive left pleural effusion was observed.
  • The effusion was secondary to a pancreaticopleural fistula.
  • The fistula originated from acute on chronic pancreatitis.

Findings:

  • Diagnosis of PPF relies on detecting elevated amylase levels in pleural fluid.
  • Magnetic resonance cholangiopancreatography (MRCP) is valuable for visualizing the fistula anatomy.
  • Clinical suspicion is paramount due to atypical initial presentations.

Implications:

  • This case highlights the importance of considering PPF in patients with unexplained pleural effusions and a history of pancreatitis.
  • Prompt diagnosis and appropriate management can prevent severe complications.
  • Further research into diagnostic and therapeutic strategies for PPF is warranted.
Keywords:
pancreaticopleural fistulapancreatitispleural effusion

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