Pancreaticopleural fistula. An unusual cause of persistent unilateral pleural effusion

There are a myriad of causes of a large persistent pleural effusion. Pancreaticopleural fistula is a rare entity seldomly included in the above differential. As it usually presents with thoracic rather than abdominal symptoms, a combination of imaging modalities, including chest radiography (CXR), computerized tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) is essential in obtaining the diagnosis.