Hemothorax as the clinical presentation of a pancreaticopleural fistula: report of a case.

Pancreaticopleural fistula is a rare complication of acute pancreatitis with pancreatic pseudocyst. We report the case of a 39-year-old man admitted for respiratory distress. Chest X-ray showed a pleural effusion, and thoracentesis yielded bloody fluid. Computed tomography (CT) scan showed a multiloculated pleural effusion and sagittal reconstruction revealed a fistulous tract between the pleura and a pancreatic pseudocyst. We treated the acute hemothorax complicating the pancreaticopleural fistula by performing urgent thoracotomy with the evacuation of blood and clots and lung decortication. We also gave the patient somatostatin and performed endoscopic retrograde cholangiopancreatography with sphincterotomy, and placed a pancreatic stent. The patient recovered well.