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Keeping the clinical picture (suggestive of pain in abdomen preceding any respiratory complaints) and differentials at hand, the case was evaluated with contrast-enhanced CT of the thorax and abdomen which revealed normal pancreatic architecture and no abnormal communication was noted between the pancreas and pleural space. A contrast oesophagogram, done when pancreatitis was ruled out, showed no evidence of any leak. The patient underwent upper gastrointestinal endoscopy which was suggestive of an ulcer with fistulous communication with the pleural space. Following nasojejunal feeding and clipping of the fistulous tract the patient\u2019s symptoms improved.<\/jats:p>","DOI":"10.1136\/bcr-2022-251160","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T09:30:12Z","timestamp":1667813412000},"page":"e251160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare case of high amylase pleural effusion without pancreatitis, oesophageal rupture or malignancy"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9852-0236","authenticated-orcid":false,"given":"Nyrvan","family":"Baishya","sequence":"first","affiliation":[{"name":"Pulmonary, Critical care and Sleep medicine, AIIMS Rishikesh, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchi","family":"Dua","sequence":"additional","affiliation":[{"name":"Pulmonary, Critical care and Sleep medicine, AIIMS Rishikesh, 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