A presentation of acute on chronic pancreatitis complicated by pancreaticopleural fistula leading to bilateral exudative pleural effusions and empyema

Authors

Ashruta Patel, DO, MS, Cleveland ClinicFollow

Abstract

This case report highlights a rare but serious complication of acute pancreatitis, where pancreatic juice drains into the pleural space, causing bilateral exudative pleural effusions and potentially leading to empyema. The patient's history of alcohol abuse and splenic vein thrombosis likely contributed to the development of this complication. The clinical presentation, including progressive shortness of breath and pleuritic chest pain, along with findings on examination and imaging, prompted further investigation. The MRI findings of a pancreaticopleural fistula, along with a pseudocyst, were significant in diagnosing the condition. Treatment involved a multidisciplinary approach, including antibiotic therapy, chest tube placement to drain the effusions, and endoscopic intervention with stent placement to address the fistula. Physicians should maintain a high index of suspicion for unusual presentations of pancreatitis, particularly in patients with predisposing factors such as alcohol abuse.

Recommended Citation

Patel, DO, MS, Ashruta (2024) "A presentation of acute on chronic pancreatitis complicated by pancreaticopleural fistula leading to bilateral exudative pleural effusions and empyema," The Journal of Integrated Primary Care: Vol. 1: Iss. 3, Article 3.
Available at: https://digitalcommons.pcom.edu/jipc/vol1/iss3/3