Postgrad Med J 2001;77:536
( August )
Self assessment questions
Massive pleural effusion
A Salih
Department of
General Surgery, Queen Mary's Hospital, Sidcup, Kent, UK
Correspondence to: Mr
A Salih, Headley Atkins, 8th Floor, New Guy's House, Guy's Hospital,
St Thomas Street, London SE1 9RT, UK
alisalih@aol.com
Submitted 8 July 1999;
Accepted 4 April 2000
| The first 150 words of the full text of this article appear below. |
A 50 year old alcoholic male patient, with
a known history of chronic pancreatitis and insulin dependent diabetes
but no past history of respiratory problems, presented with progressive
shortness of breath for a duration of three months and epigastric
discomfort for two days before admission.
On examination he was pyrexial, dyspnoeic, and tachypnoeic with
dullness and reduced air entry of the left chest. The abdomen was soft,
with slight epigastric tenderness on deep palpation.
His white cell count was 23.5 × 109/l. Serum
amylase was 2500 IU/l, serum bilirubin 81 µmol/l, and alkaline
phosphatase 1242 IU/l. Pleural aspiration yielded a bloodstained
exudative fluid with a protein concentration of 56 g/l.
Chest radiography revealed left sided massive pleural effusion (fig 1).
Computed tomography demonstrated pancreatic ductal and parenchymal
calcification (fig 2). Previous computed tomography performed a year
before revealed a pseudocyst arising from the head of pancreas,
adjacent to the left lobe of the . . . [Full text of this article]
