title: A case of eosinophilic pleural effusion induced by pancreatothoracic fistula.
abstract: A 49-year-old man was admitted for evaluation of a left pleural effusion. Thoracenthesis yielded a hemorrhagic pleural effusion with a high percentage of eosinophils (15.9%). Although there were no significant abdominal signs, serological examinations demonstrated a marked increase of pancreatic enzyme activity. Moreover, abdominal CT demonstrated cystic changes between the tail of the pancreas and the spleen. Accordingly ERP was performed under pressure, and contrast medium draining from the pancreas was observed. Pancreatic pleural effusion in this patient consisted of pancreatic juice retained in the thoracic cavity, which resulted from intrapancreatic fistulation connecting to the thoracic cavity due to a pancreatic cyst caused by chronic pancreatitis. The present report indicates that we should investigate the retention of eosinophilic pleural effusion considering not only the possibility of thoracic disease, but also the possibility of a pleural effusion derived from abdominal diseases.
authors.affiliation: Department of Internal Medicine, Mihara Medical Association Hospital, Hiroshima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Masuda
authors.forename: S
authors.initials: S
authors.lastname: Ishioka
authors.forename: K
authors.initials: K
authors.lastname: Okusaki
authors.forename: S
authors.initials: S
authors.lastname: Kashimura
authors.forename: A
authors.initials: A
authors.lastname: Tsuchida
authors.forename: T
authors.initials: T
authors.lastname: Isobe
authors.forename: M
authors.initials: M
authors.lastname: Yamakido
mesh_terms: D004802:Eosinophilia / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D010185:Pancreatic Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D016156:Respiratory Tract Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D015898:Tomography Scanners, X-Ray Computed