Massive right-sided hemorrhagic pleural effusion due to pancreatitis; a case report

BMC Pulmonary Medicine

Ashkan Mowla¹  Mohammad Reza Namazi¹ 

[1] Shiraz University of Medical Sciences, Shiraz, Iran

关键词: Cause;    Pancreatitis;    Hemorrhagic pleural effusion;   

Others  :  1172944
DOI  :  10.1186/1471-2466-4-1

 received in 2003-10-09, accepted in 2004-02-17,  发布年份 2004

【 摘 要 】

Background

Hemorrhagic pleural effusion, especially in the right hemithorax rarely occurs as the sole presentation of pancreatitis.

Case Presentation

This article reports massive right-sided hemorrhagic pleural effusion as the sole manifestation of pancreatitis in a 16-year-old Iranian boy. The patient referred to Nemazee Hospital, the main hospital of southern Iran, with right-sided shoulder and chest pain accompanied with dyspnea. His chest x-ray showed massive right-sided pleural effusion. The pleural fluid amylase was markedly elevated (8840 U/L), higher than that in the serum (3318 U/L). Abdominal CT scan showed a cystic structure measuring about 5·2 cm in the head of pancreas, highly suggestive of a pancreatic pseudocyst. Pleural effusion resolved after 3 weeks of chest tube insertion but not completely. After this period of conservative therapy another CT scan showed that pseudocyst was still in the head of pancreas. So, external drainage was done with mushroom insertion and the patient was discharged after 40 days of hospitalization. The cause of pancreatitis could not be identified.

Conclusion

Pancreatitis should be taken into consideration when hemorrhagic pleural effusion, especially in the right hemithorax occurs.

【 授权许可】

   
2004 Namazi and Mowla; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Raghu MB, Balasubraminian S, Balasubramanyam G: Hemorrhagic pleural effusion: sole manifestation of pancreatitis. Indian J Pediatr 1992, 59:767-769.
• [2]Ramsdell CM, Muslow I: Recurrent hemorrhagic pleural effusion associated with relapsing pancreatitis. South Med J 1973, 66:1016-1018.
• [3]Gupta D, Chakraborty KL, Gomber S, et al.: Massive pancreatico-pleural effusion-an often unrecognized entity. Indian J Pediatr 2001, 68(9):883-5.
• [4]Imai Y, Taniguchi M, Tagawa K, et al.: A case of chronic pancreatitis complicated by massive pericardial and right pleural effusion. Gastroenterol Jpn 1993, 28(5):734-8.
• [5]Siwczynski H: Chronic pleural effusion from the pancreas. Wiad Lek 1998, 51(3–4):190-5.
• [6]Thandroyen FT, Samson RE, Keeton GR: Hemorrhagic right pleural effusion complicating actue-on-chronic pancreatitis. S Afr Med J 1984, 65(23):933-934.
• [7]Dewan NA, Kinney WW, O'Donohue WJ Jr: Chronic massive pancreatic pleural effusion. Chest 1984, 85(4):497-501.
• [8]Uchiyama T, Suzuki T, Adachi A, et al.: Pancreatic pleural effusion: case report and review of 113 cases in Japan. Am J Gastroenterol 1992, 87(3):387-91.
• [9]Abisheganaden J, Sin Fai Lam KN, Chew LS: Massive pleural effusion in pancreatitis: 2 case reports. Singapore Med J 1995, 36(5):487-90.
• [10]Gumaste V, Singh V, Dave P: Significance of pleural effusion in patients with acute pancreatitis. Am J Gastroenterol 1992, 87(7):871-4.
• [11]Girbes ARJ, Postmus PE, Jansen W, et al.: An alcoholic with pleural effusion. Eur Respir J 1990, 3:934-936.
• [12]Svane S: Recurrent, hemorrhagic pleural effusion and eosinophilia accompanying pancreatitis. Acta Chir Scand 1966, 131:352-356.