When Pancreas Pierces Pleura: An Uncommon Case of Pancreaticopleural Fistula Managed Endoscopically
Division
Far West
Hospital
MountainView Hospital
Document Type
Case Report
Publication Date
4-14-2026
Keywords
chronic pancreatitis, endoscopic stenting, ercp, mrcp, pancreatic duct disruption, pancreaticopleural fistula, pleural effusion
Disciplines
Digestive System Diseases | Gastroenterology | Internal Medicine | Medicine and Health Sciences
Abstract
Pancreaticopleural fistula (PPF) is a rare complication of pancreatitis and typically presents with large recurrent pleural effusions. Herein, we present an unusually severe PPF in a 37-year-old woman with complete left lung atelectasis from a massive pleural effusion. Pleural fluid amylase exceeded 1500 U/L, and endoscopic retrograde cholangiopancreatography (ERCP) confirmed distal pancreatic duct disruption. The patient's course was complicated by a transdiaphragmatic pseudocyst, polymicrobial empyema, pulmonary abscess, and stent migration, requiring repeat ERCP and multiple drainage procedures. This case highlights the development of a rare thoracic complication, and demonstrates successful endoscopic management.
Publisher or Conference
Cureus
Recommended Citation
Manjikian A, Diaz V, Ryan JK. When Pancreas Pierces Pleura: An Uncommon Case of Pancreaticopleural Fistula Managed Endoscopically. Cureus. 2026;18(4):e107057. Published 2026 Apr 14. doi:10.7759/cureus.107057