Link: https://www.ncbi.nlm.nih.gov/pubmed/29804081

BMJ Case Rep. 2018 May 26;2018. pii: bcr-2018-224674. doi: 10.1136/bcr-2018-224674.
Chronic pancreatitis with Bochdalek hernia causing right-sided pleural effusion in a previously asymptomatic adult.
Yeung HM1, Kumala E2, Stanek S1, Deng X1.
Author information
Abstract
A 41-year-old man with a medical history of chronic back pain, seizure disorder, alcohol and tobacco abuse presented with acute shortness of breath. Chest X-ray showed a large right-sided pleural effusion. Pleural fluid analysis was significant for an elevated amylase level, suggestive of pleural effusion secondary to pancreatitis. Magnetic resonance cholangiopancreatography (MRCP) revealed a persistent right-sided pleural effusion in connection with a right pararenal space fluid collection via a Bochdalek hernia. An endoscopic ultrasound found hyperechoic strands and foci, and pancreatic parenchyma consistent with chronic pancreatitis, as well as a pseudocyst in the pancreatic head. A chest tube was ultimately placed to continuously drain the pleural effusion. The patient was discharged and was referred to gastroenterology for outpatient follow-up. This case illustrates a rare presentation of chronic pancreatitis with a Bochdalek hernia as a right-sided pleural effusion in a patient who was previously asymptomatic.

KEYWORDS:
GI-stents; pancreas and biliary tract; pancreatitis

PMID: 29804081 PMCID: PMC5976081 DOI: 10.1136/bcr-2018-224674
[Indexed for MEDLINE] Free PMC Article