Pancreatic pleural effusion: case report and review of 113 cases in Japan.

A patient with pancreatic pleural effusion in whom a fistulous tract was demonstrated by computed tomography (CT) is presented, and reports on 113 cases of this entity in the Japanese literature are reviewed. The most common (99%) underlying cause of this entity was chronic alcoholic pancreatitis. In most cases, the patients complained of chest symptoms (68%), and complained of abdominal symptoms less frequently (24%). It is important to maintain suspicion for this entity in patients with chronic alcoholic pancreatitis who have unexplained pleural effusion. Surgical intervention was required in 58 of 95 recorded cases. With care, the prognosis of pancreatic pleural effusion was good. Recently, as endoscopic retrograde pancreatography (ERP) and CT have been performed more frequently, the mechanisms of the pathogenesis of pancreatic pleural effusion has been determined. We stress that ERP and CT should be performed to direct surgical therapy and learn more about the mechanisms involved in the pathogenesis of pancreatic pleural effusions.