Chronic pancreatic pleural effusions and ascites.

The occurrence of pleural effusion or ascites, secondary to internal pancreatic fistula, is a rare clinical syndrome and diagnosis is, therefore, often missed. The fluid accumulation has been attributed to disruption of the pancreatic duct or to rupture of a pseudocyst. In a 20 year period, 106 patients were hospitalized in the department of surgery, CHUV, with a diagnosis of chronic or chronic relapsing pancreatitis, and 77 with that of pancreatic pseudocyst. During this time, five patients with chronic pancreatic and pleural or peritoneal effusions have been observed. These five cases present a good pattern of the possible causes and evolution of the disease. Wirsungography is of great value for the surgical management of these patients, allowing the right technique to be chosen for each particular case. Surgery caused disappearance of the effusions in our five patients.