Origin of Pleural Fluid Amylase in Esophageal Rupture

A patient with esophageal rupture and elevated pleural fluid amylase activity mimicking acute pancreatitis was studied to find the origin of the enzyme. Polyacrylamide gel electrophoretic patterns suggested that saliva was the source of elevation in this disorder. Esophageal rupture, among other disorders, can cause elevation of pleural fluid amylase, and this should be recognized to avoid attributing the abnormality to acute pancreatitis, thereby delaying surgery.