{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:31:02Z","timestamp":1793410262944,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pancreatic pseudocysts are encapsulated, enzyme\u2010rich peripancreatic fluid collections that typically develop following acute or chronic pancreatitis due to pancreatic ductal disruption. While commonly localized to the lesser sac, rare mediastinal extension may occur, presenting with nonspecific thoracic symptoms such as chest pain, dyspnea, or dysphagia. Cross\u2010sectional imaging (CT\/MRI) is essential for diagnosis. Management is individualized, ranging from conservative medical therapy to endoscopic, percutaneous, or surgical drainage based on symptom severity, complications, and anatomical considerations. We report the case of a 26\u2010year\u2010old male with a history of alcohol use and smoking, presenting with cough and dyspnea. Clinical examination revealed tachypnea, hypoxia, and signs of right\u2010sided pleural effusion. Chest X\u2010ray revealed complete opacification of the right hemithorax. Diagnostic thoracentesis yielded amylase\u2010rich pleural fluid (11,545\u2009IU\/L). Serum amylase and lipase were also elevated. Contrast\u2010enhanced CT imaging demonstrated acute necrotizing pancreatitis with peripancreatic collections extending into the thoracic cavity via the esophageal hiatus, confirming a pancreatic pseudocyst with secondary massive right\u2010sided amylase\u2010rich pleural effusion. The patient was managed conservatively with antibiotics, octreotide, and ultrasound\u2010guided pigtail catheter drainage. The clinical course was favorable, with complete symptomatic resolution and no evidence of recurrence on follow\u2010up. This case underscores a rare but significant thoracic complication of acute pancreatitis manifesting as massive pleural effusion, mimicking thoracic pathology. Thus, accurate diagnosis using contrast\u2010enhanced CT and MRCP, along with tailored management from conservative therapy to invasive drainage, is crucial. Early recognition and multidisciplinary care ensure favorable outcomes, as highlighted in this case.<\/jats:p>","DOI":"10.1002\/ccr3.71745","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T09:07:01Z","timestamp":1766999221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pancreatic Pseudocyst With Thoracic Extension: A Clinicoradiological Case Report"],"prefix":"10.1002","volume":"14","author":[{"given":"Sachchu","family":"Thapa","sequence":"first","affiliation":[{"name":"Department of Radiodiagnosis National Academy of Medical Sciences, Bir Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1905-1679","authenticated-orcid":false,"given":"Bijay","family":"Kunwar","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup","family":"Ghimire","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manthan Sanjay","family":"Shinde","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Kushwaha","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Gaire","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagdish","family":"Kunwar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash Bikram","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis National Academy of Medical Sciences, Bir Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.253045104"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2016150097"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4339"},{"issue":"1","key":"e_1_2_14_5_1","first-page":"33","article-title":"Pancreatic Pseudocyst","volume":"4","author":"Gumaste V. 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