[Pancreatic pleural fistula with bloody pleural effusion: a case report]

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis that is often overlooked in the initial differential diagnosis of pleural effusion, resulting in delays to diagnosis and treatment. This manuscript reported a case of a patient with recurrent hemorrhagic pleural effusion, in whom markedly elevated levels of amylase and lipase in the pleural fluid led to a diagnosis of pancreaticopleural fistula via magnetic resonance cholangiopancreatography (MRCP). This case aimed to raise awareness among clinicians about the importance of considering uncommon etiologies in the differential diagnosis of pleural effusion, and highlights the significance of elevated amylase levels in pleural fluid for the diagnosis of pancreaticopleural fistula. Although there is a lack of clear treatment guidelines for this disease, treatment typically involves addressing the underlying disease. Placement of stents through endoscopic retrograde cholangiopancreatography (ERCP) is also a feasible method, and early diagnosis and treatment can prevent long-term complications or mortality.