Black Pleural Effusion as a Complication of Acute Pancreatitis

Arumairaj, A.J.; Davalos, Fidencio; Bamgboje, Abayomi; Habtes, Imnett

doi:10.1016/j.chest.2020.08.1147

Cited by 2 publications

(11 citation statements)

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“…Data of 32 patients with black pleural effusion patients extracted and reported from 31 eligible articles are summarized in Tables 1 and 2 concerning demographics and admission to hospital diagnosis [6–9,12–38] . The flow of information through the different phases of our systematic review is depicted in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The causes of black pleural effusion (BPE) range from infection, rheumatoid arthritis, pleuroperitoneal fistula, and malignancy [5] . Given the paucity of literature and the rare occurrence of BPE, we aimed to perform a systematic review to characterize the manifestations, underlying diagnosis, and outcomes related to BPE to guide clinicians in managing this condition [5–9] …”

Section: Introductionmentioning

confidence: 99%

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Etiology, pathological characteristics, and clinical management of black pleural effusion

et al. 2022

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Background: Pleural effusion is characterized by excessive fluid collection in the pleural cavity. Black pleural effusion (BPE) is a rare entity with only limited scientific data. We aimed to review the current literature on black pleural effusion to characterize demographics, etiology, clinical presentation, pathological findings, available treatment strategies, and prognosis of this rare condition.Methods: We performed a systematic review of case reports and series and synthesized data on demographics, manifestations, management, and outcomes of patients with BPE. We searched Cochrane Library, PubMed, SCOPUS, and Google Scholar for any date until January 10, 2021. All studies (n = 31) that reported black pleural effusion in patients were added to the review. Prospective Register of Systematic Reviews registration number: CRD42020213839. Summary and descriptive analysis was performed on Jamovi version 1.2.Results: The mean age of 32 patients with BPE was 53 years, with male predominance (69%). The commonest risk factor was smoking (n = 9) followed by alcohol intake (n = 8). Dyspnea was the commonest symptom (n = 24, 75%). Pleural fluid was mostly exudative (n = 21). The commonest associated diagnosis was malignancy (n = 14), with 50% secondary to metastatic melanoma. The commonest intervention was therapeutic thoracocentesis (n = 25, 78%), and the effusion recurred in half of the cases where recurrence was reported (n = 13). In our review, we found the mortality rate to be at 20.8% (n = 20.8%). 58.3% of the patients were successfully treated and discharged home (n = 14). Conclusion:Although rare, BPE appears to be a relevant symptom as it seems to be frequently associated with modifiable risk factors and underlying malignancy. Our systematic review substantiates a vital research gap as observational research is imperative to characterize BPE further and form a basis for designing tailored diagnostic, preventive, and therapeutic strategies for BPE.Abbreviations: BPE = black pleural effusion, PNSCC = pulmonary non-small cell carcinoma, PROSPERO = Prospective Register of Systematic Reviews.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Etiology, pathological characteristics, and clinical management of black pleural effusion

et al. 2022

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“…[10] Of those, 8 cases were caused by alcoholic pancreatitis, while the remaining case was induced by idiopathic pancreatitis. [2][3][4][5][6][7][8][9]15] Almost all (99%) pancreaticopleural fistulae associated with a pancreatic pseudocyst are caused by alcoholic pancreatitis. [16] Thus far, cases of pancreatic pseudocysts in autoimmune pancreatitis have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Female Idiopathic Surgery Guo F, [15] 2017 54 Male Alcohol TD and endoscopic pancreatic duct drainage Ishigaki S, [8] 2019 48 Male Alcohol TD and EUS-guided drainage Arumairaj A, [9] 2020 ENPD = endoscopic nasopancreatic drainage, EUS-guided drainage = endoscopic ultrasoundguided pancreatic pseudocyst drainage, PDS = pancreatic duct stent placement, TD = thoracic drainage.…”

Section: Age (Years) Sex Etiology Treatmentmentioning

confidence: 99%

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Black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis: A case report

et al. 2022

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Rationale: Black pleural effusion is a rare medical condition and a diagnostic marker. Pancreaticopleural fistula is one of the causes of black pleural effusion. Thus far, black pleural effusions caused by pancreaticopleural fistulae have mostly been reported in patients with alcohol-induced chronic pancreatitis. In this report, we present a case of black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis. Patient concerns and diagnosis:A 59-year-old female without a history of alcohol drinking presented to our hospital with a chief complaint of dyspnea, as well as chest and back discomfort. She had left pleural effusion, and thoracentesis showed black pleural effusion. Computed tomography revealed the presence of encapsulated fluid from the pancreatic tail to the left pleural cavity, which was diagnosed as a pancreaticopleural fistula. It also showed diffuse pancreatic swelling. Serum testing showed a high IgG4 level (363 mg/dL). These findings led to the diagnosis of autoimmune pancreatitis. Interventions and outcome:The patient underwent endoscopic pancreatic sphincterotomy and pancreatic duct stent placement and received treatment with steroids. After treatment, there was no further accumulation of pleural effusion observed.Conclusion: This is the first report of black pleural effusion due to a pancreaticopleural fistula associated with autoimmune pancreatitis. The characteristic appearance of black pleural effusion may assist diagnosis. We report this case to emphasize that autoimmune pancreatitis can be a cause of black pleural effusion.

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Black Pleural Effusion as a Complication of Acute Pancreatitis

Cited by 2 publications

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Etiology, pathological characteristics, and clinical management of black pleural effusion

Etiology, pathological characteristics, and clinical management of black pleural effusion

Black pleural effusion caused by a pancreaticopleural fistula associated with autoimmune pancreatitis: A case report

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