A Young Man With Dyspnea
A 37-year-old man presented to the emergency room complaining of dyspnea of increasing severity over the last few days. He related having suffered a bout of acute pancreatitis a few months previously, probably due to high alcohol consumption; as far as he knew, he had no other illnesses. Ultrasonography revealed a large, anechoic left pleural effusion, in apparent continuity with a cyst-like fluid collection in the abdomen. Computerized tomography of the chest and abdomen revealed a pancreatic pseudocyst measuring 30 × 11 cm and a large accompanying left-sided pleural effusion, with atelectasis of the upper and lower lobes. No connection between the pseudocyst and the effusion was evident. There was no laboratory evidence of recurrent pancreatitis (the lipase and c-reactive protein [CRP] values were in the normal range). As the patient had no other known illnesses, a sympathetic pleural effusion in the aftermath of acute pancreatitis was diagnosed. The patient’s dyspnea rapidly improved after a chest tube was inserted and 2.5 liters of fluid were drained out of the left hemithorax. The pancreatic pseudocyst was drained as well, under ultrasonographic guidance, yielding a further 3 liters of fluid. The patient was asymptomatic on discharge from the hospital eight days after admission.
PD Dr. med. Markus Wehler, Dr. med. Patrik Htun, Zentrale Notaufnahme und IV. Medizinische Klinik, Klinikum Augsburg, Markus.firstname.lastname@example.org
Andreas Adam, Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg
Conflict of interest statement
The authors state that they have no conflict of interest. / Translated from the original German by Ethan Taub, M.D.
Cite this as:
Wehler M, Adam A, Htun P: A young man with dyspnea. Dtsch Arztebl Int 2017; 114: 185. DOI: 10.3238/arztebl.2017.00185