Haemorrhagic right pleural effusion complicating acute-on-chronic pancreatitis. A case report

A 40-year old man presented with pulmonary symptoms and a right-sided haemorrhagic pleural effusion. Tuberculosis and carcinoma, both primary and secondary, were excluded as a cause. Chronic pancreatitis was diagnosed on the basis of a 5-year history of repeated episodes of alcohol-induced epigastric pain and suggestive findings on endoscopic retrograde cholangiopancreatography. The chronic pancreatitis became acute during hospitalization. The disproportionate elevation of the pleural fluid amylase level in comparison with the serum amylase level provided definitive evidence that the pleural effusion was a complication of pancreatitis.