[Pancreaticopleural fistula formation: a rare complication in chronic pancreatitis]

Pleural effusions are found in 3 to 17% of patients with chronic pancreatitis. The most likely underlying pathogenetic mechanism is transdiaphragmatic lymphatic transfer of pancreatic secretions to the subpleural space, whilst a rare cause is the formation of pancreatico-pleural fistulae. The measurement of amylase activity in the pleural fluid has considerable diagnostic value and in most cases the diagnosis is verified by endoscopic retrograde pancreaticography (ERP). A case report is presented and forms the basis for a discussion of pathogenesis, diagnostic problems and therapeutic management of pleural effusions in chronic pancreatitis.