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Bilateral Pleural Pancreatic Fistula: A Rare Case Report.
Sanjay Gabhale1, Parna Chakraborty2, Brahmansh Singh2
1Department of Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Maharashtra, India.
Annals of African Medicine
|January 22, 2026
Summary
This case report details the successful management of a rare bilateral pancreatico-pleural fistula (PPF) caused by alcohol-induced pancreatitis. A multi-modal approach involving drainage and endoscopic stenting led to significant patient improvement.
Area of Science:
- Gastroenterology
- Pulmonology
- Interventional Endoscopy
Background:
- Pancreatico-pleural fistula (PPF) is a rare complication of pancreatitis.
- Bilateral PPF presentation is exceptionally uncommon.
- This report focuses on a case of alcohol-induced pancreatitis complicated by bilateral PPF.
Purpose of the Study:
- To describe the successful management of a rare bilateral pancreatico-pleural fistula.
- To highlight the effectiveness of a multi-modal treatment approach.
Main Methods:
- A 40-year-old male with alcohol-induced pancreatitis presented with epigastric pain and dyspnea.
- Imaging confirmed bilateral pleural effusions and pancreatic duct communication.
- Management involved bilateral chest tube drainage and endoscopic pancreatic duct stenting.
Main Results:
- The patient exhibited significant clinical improvement after combined therapy.
- Elevated pleural fluid amylase and lipase levels indicated pancreatic origin.
- Discharge occurred after 32 days with a pancreatic duct stent in place.
Conclusions:
- Bilateral pancreatico-pleural fistulas require consideration in patients with unexplained pleural effusions.
- A multi-modal strategy combining conservative and endoscopic interventions is effective for managing bilateral PPF.
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