Young Patient with Right Sided Pleuro-Pancreatic Fistula-An Unusual Presentation

Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging like CT&MRCP aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis. Patient was successfully managed by ERCP guided sphincterotomy with removal of stone followed by stenting of pancreatic duct.