Recurrent Chylothorax: A Rare Complication of Acute Necrotizing Pancreatitis With Necrosectomy and Stent Placement for Pseudocyst

TL;DR

A rare case of chylothorax caused by necrotizing pancreatitis is reported, highlighting unusual complications and treatment approaches.

Contribution

This report adds to the limited literature on chylothorax as a complication of necrotizing pancreatitis.

Findings

Chylothorax occurred as a complication of necrotizing pancreatitis in a patient with prior stent placement and necrosectomy.

The patient required multiple thoracenteses and chest tube placement for symptom management.

Inflammatory changes in the pancreas were linked to chyle leakage into the pleural cavity.

Abstract

Chylothorax is an abnormal collection of chyle in the pleural space that requires prompt intervention. This case report describes a 47-year-old female who presented with recurrent chylothorax as a complication of necrotizing pancreatitis. She was initially evaluated for acute respiratory distress. Chest radiograph showed a large right-sided pleural effusion requiring multiple thoracenteses followed by chest tube placement for symptomatic relief. The patient had a history of acute necrotizing pancreatitis status post cystogastrostomy with axios stent placement and necrosectomy for pseudocyst three years before her presentation. This report highlights inflammatory changes in the pancreas leading to chyle leakage in the pleural cavity. To our knowledge, there are only a few reported cases in the literature. Diagnosis, evaluation, and management explained.

Figures