[A case of mediastinal pancreatic pseudocyst with pancreatic pleural effusion in which internal fistula was diagnosed by magnetic resonance image].

A 53-year old man with a history of heavy alcoholic drinking was admitted for progressive cough and dyspnea. Chest radiography revealed a left-sided massive pleural effusion, and CT showed a pancreatic pseudocyst occurred from the body of the pancreas to mediastinum. MRI images clearly delineated the internal pancreatic fistula that extended to the mediastinum. A distal pancreatectomy with splenectomy was performed and the postoperative course was uneventful without recurrent pancreatitis or pleural effusion. MRI is a useful noninvasive imaging method to assess mediastinal pancreatic pseudocysts.