Abstract
RATIONALE: Pancreaticopleural fistula (PPF) is a rare but serious complication of pancreatic disease, typically resulting from the rupture of a pancreatic pseudocyst or ductal injury. The condition often leads to misdiagnosis due to its nonspecific clinical manifestations, including dyspnea and chest pain. PATIENT CONCERNS: A 61-year-old male with a history of alcohol and tobacco use presented with severe dyspnea, chest pain, and cough. He had been diagnosed with acute pancreatitis 9 months prior and intermittently experienced upper abdominal pain and distension post-treatment. DIAGNOSES: PPF. INTERVENTIONS: The patient underwent thoracic drainage, nasopancreatic duct drainage, and pancreatic duct stent placement, along with parenteral nutrition and somatostatin therapy. OUTCOMES: Treatment resulted in resolution of pleural effusion and pseudocyst. The patient had no recurrence during a 5-year follow-up period. LESSONS: This case demonstrates the effectiveness of a comprehensive treatment strategy combining thoracic and pancreatic drainage for PPF. Long-term follow-up is crucial for monitoring recurrence and assessing treatment efficacy. Future research should focus on optimizing treatment plans, particularly regarding the best timing for intervention and improving long-term outcomes.