A 40 year-old male with a history of ten years of substantial alcohol abuse, presents to the emergency room, complaining of trepopnea, right-sided chest pain and upper abdominal discomfort. Abdominal examination unveiled disseminate tenderness. Chest radiography revealed large right-sided pleural effusion (Figure 1). Computed tomography of the thorax showed massive right pleural effusion without pseudocyst (Figure 2). Thoracentesis revealed hemorrhagic fluid. Cytology for malignancy was negative. Biochemical analysis exudative fluid with a lipase of 7653 units per liter and an amylase of 3976 units per liter was found. Ultrasound scan of abdomen uncovered large ascites with echogenic fluid and an overshadowed pancreas. Esophagography demonstrated no discharge of contrast. Upper gastrointestinal endoscopy was normal. Endoscopic retrograde cholangiopancreatography with endoscopic pancreatic stent placement was performed.
展开▼
