Abstract
Pleural effusion most commonly has a cardiac or pulmonary etiology. Gastrointestinal/intra-abdominal causes include hepatic failure associated with ascites, malignancy, ruptured ectopic pregnancy, esophageal rupture, and pancreatitis. Sympathetic pleural effusion can complicate acute pancreatitis,1,2 and large pleural effusions may arise in the setting of chronic pancreatitis. Pancreatic ductal disruption can lead to fistulous tracts that extend along the esophageal and aortic hiati into the mediastinum.3 Additionally, direct penetration of fistulous tracts or intra-abdominal pseudocysts through the dome of the diaphragm into the pleural cavity are described.4-6 This is a case of pancreaticopleural fistula that presented with a massive pleural effusion as a manifestation of pancreatitis and a report of the successful treatment with nasopancreatic drainage.
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