CTICasesPancreatitis with Pancreatic Pseudocyst Eroding through the Diaphragm
Imaging findings
CT demonstrates a large fluid collection in the left chest contiguous with the pancreas, passing directly through the left hemidiaphragm (rather than via the hiatus), representing erosion of a pancreatic pseudocyst through the diaphragm into the thoracic cavity.
Key takeaways
Pancreatitis and its fluid collections can track through the diaphragmatic hiatus or, less commonly, erode directly through the diaphragm itself into the pleural space. The pancreatic enzymes are directly cytotoxic and can digest tissue planes. Recognizing the transdiaphragmatic nature of the collection is important for appropriate drainage and surgical planning.
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