A Rare Cause of Right Hemothorax: A Case Report on Rupture of Splenic Artery Pseudoaneurysm via Pancreatico-Pleural Fistula

Introduction: Pancreatico-pleural fistula is a well-known complication in patients with pancreatitis, presenting with pleural collections, which may be hemorrhagic or nonhemorrhagic. The source of hemorrhage in most of the reported cases was of pleural origin, rather than an abdominal source communicating with the pleural cavity. Case Presentation: We report a case of pancreatic pseudocysts and pancreatico-pleural fistula associated with chronic pancreatitis, presenting with right hemothorax and related respiratory symptoms, caused by a ruptured splenic artery pseudoaneurysm (PSA). Conclusion: We present a brief overview of the presentation, diagnostic workup and treatment options for a rare presentation of pancreatico-pleural fistula. This report highlights the importance of considering unusual sources of bleeding in unexplained hemothorax associated with pancreatico-pleural fistula and the need for multiple sequential interventions for its management.