Pancreatic ascites

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Chronic recurrent abdominal pain with ascites. History of alcohol abuse.

Patient Data

Age: 60 years
Gender: Male
CT

CT evidence of pancreatitis and pseudocysts.

Liver and gallbladder is normal. Portal vein is patent.

CT

1 year later

Interval progression of pseudocysts and ascites. Normal liver, portal vein and spleen. Mildly dilated pancreatic duct is seen.

CT

18 months after first CT

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.

PlayAdd to Share

Case information

rID: 68980
Published: 1st Jul 2019
Last edited: 10th Oct 2019
Inclusion in quiz mode: Included
Institution: Augusta University

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.