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Miscellaneous
Chronic pancreatitis and dyspnoea
  1. H Pauka1,
  2. M B Frenz1,
  3. A Riphaus1,
  4. I Pohl2,
  5. T Wehrmann3
  1. 1Department of Gastroenterology, Klinikum Hannover Siloah, Hannover, Germany
  2. 2Department of Radiology, Klinikum Hannover Siloah, Hannover, Germany
  3. 3Department of Gastroenterology, Klinikum Hannover Siloah, Hannover, Germany
  1. Correspondence to:
    Dr H Pauka
    Department of Gastroenterology, Klinikum Hannover Siloah, Roesebeckstr 15, 30449 Hannover, Germany; HKPauka{at}t-online.de

http://dx.doi.org/10.1136/gut.2005.080366

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    Clinical presentation

    A 53 year old man was admitted with dyspnoea. Clinical examination and chest x ray (fig 1) suggested a large right sided pleural effusion. A spiral computed tomography scan of the chest was performed (fig 2).

    Figure 1
    Figure 1

     Chest x ray on admission.

    Figure 2
    Figure 2

     Computed tomography of the chest with three dimensional reconstruction (sagittal view).

    He had a previous history of long term alcohol abuse with known chronic pancreatitis. There was no other relevant past medical history and he was not taking any regular medications.

    During his hospital stay the patient developed abdominal pain. Laboratory investigations showed leucocytes of 12 000/μl, C reactive protein of 27.20 mg/dl, and haemoglobin of 10.4 g/dl. Serum α-amylase was 174 U/l and lipase 128 U/l.

    Question

    What does the computed tomography scan of the chest show? What is the possible explanation for this finding?

    See page 894 for answer

    This case is submitted by:

    Footnotes

    • Robin Spiller, Editor

    Linked Articles

    • Miscellaneous
      Answer
      BMJ Publishing Group Ltd and British Society of Gastroenterology
      Gut 2006; 55 894-894 Published Online First: 11 May 2006.