Hemothorax as the Clinical Presentation of a Pancreaticopleural Fistula: Report of a Case

Abstract

Pancreaticopleural fistula is a rare complication of acute pancreatitis with pancreatic pseudocyst. We report the case of a 39-year-old man admitted for respiratory distress. Chest X-ray showed a pleural effusion, and thoracentesis yielded bloody fluid. Computed tomography (CT) scan showed a multiloculated pleural effusion and sagittal reconstruction revealed a fistulous tract between the pleura and a pancreatic pseudocyst. We treated the acute hemothorax complicating the pancreaticopleural fistula by performing urgent thoracotomy with the evacuation of blood and clots and lung decortication. We also gave the patient somatostatin and performed endoscopic retrograde cholangiopancreatography with sphincterotomy, and placed a pancreatic stent. The patient recovered well.

Pancreaticopleural Fistula: A Review of Imaging Diagnosis and Early Endoscopic Intervention

“…Inclusion was limited to cases reported in the English or Spanish language between 2007 and 2017 who underwent early ERCP alone or before any operative management. Forty-three patients (including the patient in this study) with PPF were reported during the 2007-2017 period [2, 4–36]. Data is presented as percentage or mean values ± standard deviation (SD).…”