[A case of mediastinal pancreatic pseudocyst accompanied by pancreatic pleural effusion].

A 52-year-old man was admitted with epigastric and back pain. Chest X-ray and whole body CT scan revealed left massive pleural effusion and cystic lesion in the posterior mediastinal compartment extending to the pancreatic body via the esophageal hiatus. MRCP showed the communication between the cystic lesion and main pancreatic duct which was irregularly dilated. Thoracentesis revealed sterile bloody fluid with markedly elevated amylase activity of 5,770 IU/l (pancreatic isozyme, 100%) and no malignant cells. From these examinations, a diagnosis of chronic alcohol-related pancreatitis accompanied by mediastinal pancreatic pseudocyst and pancreatic pleural effusion was made. We employed conservative therapy including chest tube drainage followed by operation (main pancreatic duct jejunal side-to-side anastomosis). The clinical course has been uneventful for more than 1 year after discharge.