Dhanani Zehra, Dachert Stephen
Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA, United States.
Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States.
Respir Med Case Rep. 2025 Jan 1;53:102163. doi: 10.1016/j.rmcr.2024.102163. eCollection 2025.
Pancreatopleural fistulas, rare complications of chronic pancreatitis, are often overlooked in the initial differential diagnoses of pleural effusions, resulting in delayed diagnosis and management. We present the case of an elderly male with recurrent pleural effusion and a history of chronic pancreatitis. Diagnostic challenges arose, with the initial misdiagnosis as pneumonia. Elevated pleural fluid amylase levels (11,370U/L) along with imaging findings led to the diagnosis of a pancreatopleural fistula. This case underscores the importance of considering uncommon etiologies in pleural effusions and highlights the significance of high pleural fluid amylase levels in diagnosing pancreatopleural fistulas.
胰胸膜瘘是慢性胰腺炎的罕见并发症，在胸腔积液的初始鉴别诊断中常被忽视，导致诊断和治疗延迟。我们报告一例老年男性，有复发性胸腔积液及慢性胰腺炎病史。诊断过程中出现了挑战，最初误诊为肺炎。胸腔积液淀粉酶水平升高（11370U/L）以及影像学检查结果最终确诊为胰胸膜瘘。该病例强调了在胸腔积液中考虑罕见病因的重要性，并突出了高胸腔积液淀粉酶水平在诊断胰胸膜瘘中的意义。
