A 60-year-old man with chronic pancreatitis caused by alcohol consumption (70 units per week) had a six-month history of shortness of breath, pain on the left side of the chest, and swelling of the left thigh. Laboratory tests showed significantly increased levels of pancreatic enzymes - amylase (722 U/l with a norm of 44–132 U/l) and lipase (1068 U/l with a norm of 16–51 U/l). Computed tomography revealed a left-sided pleural effusion, cystic lesions extending from the retroperitoneum to the left thigh, and pancreatic calcifications. Endoscopic retrograde cholangiopancreatography confirmed pancreaticopleural and pancreatoperitoneal fistulas associated with pancreatic tail pseudocyst. These fistulas allow pancreatic secretions to escape from the pancreas into the pleural cavity and peritoneum.