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Pancreatic ascites managed with a conservative approach: a case report
Raju Bhandari1, Rajan Chamlagain2, Saraswati Bhattarai2
1Department of General and GI Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. rbiom27@gmail.com.
Journal of Medical Case Reports
|September 15, 2020
Summary
Pancreatic ascites, a rare condition of massive fluid accumulation in the abdomen, is often caused by chronic alcoholic pancreatitis. Diagnosis involves elevated ascitic fluid amylase, and management can be conservative or interventional.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pancreatology
Background:
- Pancreatic ascites is a rare condition characterized by massive pancreatic fluid accumulation in the peritoneal cavity.
- Chronic alcoholic pancreatitis is the most frequent etiology, distinct from ascites due to portal hypertension in alcoholic liver disease.
Observation:
- A 53-year-old male with chronic alcoholism presented with epigastric pain and abdominal distension.
- Elevated serum amylase, lipase, and ascitic fluid amylase, along with decreased serum calcium, were noted.
- Abdominal CT scan indicated acute-on-chronic pancreatitis.
Findings:
- The diagnosis of pancreatic ascites was supported by significantly elevated ascitic fluid amylase levels.
- The patient's presentation was consistent with acute-on-chronic pancreatitis.
Implications:
- Pancreatic ascites diagnosis relies on elevated ascitic fluid amylase in the context of pancreatic disease.
- Management strategies include conservative measures (nutritional support, drainage) and interventional approaches.
- This case highlights successful conservative management of pancreatic ascites.
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