Bilateral pleural effusion of pancreatic etiology: A rare case report

Abstract

Pleural effusions occuring as a result of acute or chronic pancreatitis are usually transient, short lived and are easily curable if the diagnosis is identified. It is mostly left sided and less likely right sided and very rarely bilateral. We are hereby reporting a case of a 38 year old male patient who was a chronic alcoholic who was symptomatic for left sided pleural effusion. Pleural fluid examination revealed high amylase levels suggesting a pancreatic etiology for the effusion. After 1 week of hospitalisation, the patient developed right sided effusion in addition to the left sided effusion. Unilateral or bilateral exudative pleural effusion of unknown etiology and elevated pleural fluid amylase should be suspected as pleural effusions with an underlying pancreatic pathology. The pathology in the pancreas was confirmed with the radiological investigations supportive of pancreatitis. Pancreatitis not only develop haemorrhagic pleural effusion, it also produce bilateral pleural effusion. Elevated amylase levels in pleural fluid is suggestive of pancreatic aetiology. Timely surgical intervention like E will reduce the pleural effusion and improves survival.