Presentation
Abdominal pain.
Patient Data
Age: 40 years.
Gender: Male
From the case:
Pancreaticopleural fistula in pancreatitis
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/119409/annotated_viewer_json?lang=us"}
Massive left pleural effusion displacing the mediastinum to the right.
From the case:
Pancreaticopleural fistula in pancreatitis
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/119410/annotated_viewer_json?lang=us"}
Pancreatic stent placed using a duodenal approach. Contrast in the gall bladder/biliary tree. Peripancreatic fluid collections are consistent with pancreatitis. Large left pleural effusion with possible fistulous connection best seen in the coronal plane (see annotated image below) with one of the peripancreatic fluid collections.
From the case:
Pancreaticopleural fistula in pancreatitis
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/119412/annotated_viewer_json?lang=us"}
The red arrow shows a possible fistulous connection between a peripancreatic fluid collection and the left pleural space.
Case Discussion
Remember that intra-abdominal abnormalities may cause pleural effusions. This patient's pleural effusion was tapped and had extremely high levels of amylase.
Unable to process the form. Check for errors and try again.