2019 Volume 41 Issue 5 Pages 436-440
Background. Pleuroscopy is useful when making a definite diagnosis of pleural effusion of unknown etiology. We encountered a patient with pleural effusion of unknown etiology who was examined by pleuroscopy under local anesthesia, and diagnosed with pancreatic pleural effusion, which was later complicated by a mediastinal pancreatic pseudocyst. Case. A 39-year-old woman was admitted to a neighborhood hospital. She had a history of alcohol pancreatitis last year. Chest X-ray showed massive pleural effusion on the right side of the lung. Thoracentesis was performed but a definitive diagnosis could not be made. Pleuroscopy revealed diffuse redness, swelling, and fibrous hypertrophy on the pulmonary apex and the dorsal posterior pulmonary wall. The amylase level in the pleural effusion was high and MRCP revealed a mediastinal pancreatic pseudocyst. We determined a mediastinal pancreatic pseudocyst accompanied by pancreatic pleural effusion. Conclusion. When pleural effusion of unknown etiology is noted in patients with repeated alcoholic pancreatitis, mediastinal pancreatic pseudocyst should be considered in the differentiation.
