Conservative Management of Pancreatic Ascites

Abstract

A case of recurrent ascites occurring in a young man with a long history of excessive alcohol intake and recurrent attacks of abdominal pain is reported. High amylase activity in the peritoneal fluid suggested pancreatic disease. The case demonstrated several of the features associated with pancreatic ascites. ERCP showed marked changes consistent with chronic pancreatitis and a pancreaticoperitoneal fistula arising in the region of the head of the pancreas was demonstrated. The patient recovered completely after periodic paracentesis and a regimen of hyperalimentation without oral'intake.Case report A 29-year-old man with a long history of heavy alcohol intake was referred to Hammersmith Hospital in June 1984 with episodes of diarrhoea. In

Internal Pancreatic Fistulae - Management Review

“…It was thought that pancreatic ascites was the consequence of postinflammatory lymphatic stasis (5). The true pathogenesis of the event was recognized with the use of endoscopy in the 80s and 90s (1,6,7). The treatment of pancreatic ascites was repeated paracentesis and effusion evacuation (3,5).…”

“…Pancreatic juice in ascetic fluid is not activated. Thus, PA doesn't produce typical peritoneal irritation nor enzymatic necrosis, although it is potentially a proteolytic and lypolytic agent (7,10,11).…”