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CASE REPORT
Year : 2016  |  Volume : 4  |  Issue : 2  |  Page : 218-221

Pancreatic pleural effusion: A diagnosis not to be missed!


1 Department of Internal Medicine, Tata Main Hospital, Tata Steel, Jamshedpur, Jharkhand, India
2 Department of Pulmonary Medicine, Tata Main Hospital, Tata Steel, Jamshedpur, Jharkhand, India

Correspondence Address:
Sangita Kamath
Department of Internal Medicine, Tata Main Hospital, Tata Steel, Jamshedpur, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.196206

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Pleural effusion as a consequence of acute pancreatitis is transient, usually left-sided; straw colored and accounts for 1% of all the cases. Rarely, it may be right-sided and hemorrhagic causing difficulty in establishing the diagnosis, especially if the chest symptoms are disproportionately more than the abdominal symptoms. We present a case of a young alcoholic male patient with a history of inadequately treated tuberculosis in the past, who presented with massive right pleural effusion, ascites, and right hydrocele and was overtly symptomatic for 1 week before hospital admission. Evaluation of pleural fluid revealed hemorrhagic, lymphocyte predominant exudate with low Adenosine Deaminase (ADA) and high amylase level. Ascitic fluid too showed similar characteristics. His serum amylase level was also elevated which prompted us to make a clinical diagnosis of pancreatic pleural effusion with ascites. Further radiological investigations confirmed the diagnosis of acute pancreatitis. Early pleural fluid amylase testing will certainly avoid a delay in the timely diagnosis.


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