Straw coloured Right sided Pleuropancreatic effusion: a diagnosis not to be missed

Abstract

Pleural effusion secondary to chronic pancreatitis is an uncommon condition accounting for less than 1% of
patients and usually left sided, haemorrhagic. Rarely it may be right sided and straw coloured causing difficulty in
establishing the diagnosis, especially if the chest symptoms are disproportionally more than abdominal
symptoms. We report a rare case of 41 years old alcoholic male who had history of right sided chest pain, cough
with expectoration, breathlessness, abdominal pain for 2 months. Pleural fluid examination suggested straw
coloured, lymphocytic predominant exudate with law adenosine deaminase and high lipase and amylase level. To
rule out alcoholic pancreatitis CT scan thorax and abdomen was done, which demonstrated pancreatic
pseudocyst and right sided gross pleural effusion. Conservative treatment was given in form of intercostal chest
tube drainage, higher antibiotics, somatostatin analogue low fat diet for three to four weeks.