A case of pancreatic pleural effusion presenting as metachronous bilateral hemothorax in a patient with acute pancreatitis

Abstract

A 40-year-old man with a history of acute pancreatitis was admitted for right-sided chest pain. Chest X-ray showed a massive right pleural effusion. A pancreatic pleural effusion due to rupture of a pancreatic pseudocyst was diagnosed based on thoracentesis and a computed tomography (CT) scan. The patient was successfully treated with drainage of the right-sided thoracic cavity. Three months later he was readmitted for left-sided chest pain. Chest X-ray showed a massive left pleural effusion. Coronal CT reconstruction revealed a pancreaticopleural fistula between the left-sided thoracic cavity and the dilated main pancreatic duct. We diagnosed a pancreatic pleural effusion due to a pancreaticopleural fistula with exacerbation of acute pancreatitis. Therefore, the patient underwent distal pancreatectomy to remove the disrupted main pancreatic duct. The patient had a good postoperative course and has remained well during 13 months of follow-up.