# A Rare Case of Pancreaticopleural Fistula That Presented as a Recurrent Pleural Effusion at a Regional Hospital in Guyana

## TL;DR

A 43-year-old man with a history of alcohol abuse developed a rare pancreaticopleural fistula, leading to recurring pleural effusion, which was surgically treated in a setting without advanced endoscopic tools.

## Contribution

This case highlights the management of a rare pancreaticopleural fistula in a resource-limited setting using surgical intervention.

## Key findings

- MRI confirmed the presence of a pancreaticopleural fistula in a patient with recurrent left pleural effusion.
- Surgical distal pancreatectomy was performed due to lack of access to octreotide and endoscopic procedures.
- The patient recovered well post-surgery with no complications at a 3-month follow-up.

## Abstract

Pancreaticopleural fistula is a rare complication of pancreatitis. We present a rare case of pancreaticopleural fistula in a 43-year-old alcoholic male. He presented with recurrent episodes of left pleural effusion that were managed with aspiration and chest tube placement. An MRI of the chest and upper abdomen revealed a pancreaticopleural fistula. The patient underwent distal pancreatectomy with splenectomy and Roux-en-Y pancreaticojejunostomy. The surgical approach was our first-line management due to the unavailability of octreotide and endoscopic retrograde cholangiopancreatography. His recovery was complicated by an empyema that was managed by tube thoracostomy and IV antibiotics. There was no issue detected at his 3-month follow-up clinic visit.