A pancreatic pseudocyst with pancreatic pleural effusion: report of a case.

A 54-year-old man with a 30-year history of chronic alcoholism was admitted to our hospital suffering from dyspnea and left-sided chest pain. A chest radiograph revealed pleural effusion. Computed tomography revealed a pancreatic pseudocyst in the tail of the pancreas spreading out to the posterior mediastinum and the left pleural cavity. The laboratory findings of pleural effusion were as follows: amylase, 118,400 IU/1; protein, 4.6 g/dl; class I in cytology. Despite a reduction in the pleural effusion by conservative therapy, left back pain and a recurrence of the pleural effusion were observed after oral intake was re-initiated. A distal pancreatectomy and ligation of the pancreaticopleural fistula were thus performed on the 75th hospital day. The patient made a complete recovery from pancreatic pleural effusion and has now been well for 9 years.