Pancreaticopleural fistula: Revisited

Norman Oneil MacHado*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)


Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP) or magnetic resonance cholangiopancreaticography (MRCP) may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.

Original languageEnglish
Article number815476
JournalDiagnostic and Therapeutic Endoscopy
Publication statusPublished - 2012

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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