Internal pancreatic fistula to the pericardium and pleura

A report of a 38-year-old man with a 10 month course of illness characterized by recurrent pericardial and pleural high-protein, high-amylase effusions is presented. Operative pancreatogram demonstrated fistulization from the mid-pancreas through the mediastinum into both pleural spaces and the pericardium. Surgical detachment of the fistula and Roux-en-Y decompression of the pancreatic duct resulted in cure of the condition.