Presentation
Chronic recurrent abdominal pain with ascites. History of alcohol abuse.
Patient Data
CT evidence of pancreatitis and pseudocysts.
Liver and gallbladder is normal. Portal vein is patent.
Interval progression of pseudocysts and ascites. Normal liver, portal vein and spleen. Mildly dilated pancreatic duct is seen.
Liver small and shrunken.
Pancreas showing signs of chronic pancreatitis.
Large volume ascites, loss of retro peritoneal fat and subcutaneous fat.
Case Discussion
This was a case of pancreatic ascites proven by elevated amylase in the ascitic fluid. This patient was managed medically safely by large-volume paracentesis. He is doing well and free of ascites 2 years later.
Pancreatic ascites is usually due to disruption of the pancreatic duct, but as this case shows, one can get pancreatic ascites from severe pancreatitis without duct disruption and resolution is possible with conservative management.
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