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Hereditary pancreatitis presenting with ascites.

S S Rao, S A Riley, P N Foster

    Postgraduate Medical Journal
    |September 1, 1986
    PubMed
    Summary

    A rare case of hereditary pancreatitis caused pancreatic ascites in an adolescent girl, leading to delayed diagnosis and unnecessary surgery. Early measurement of serum and ascitic amylase is crucial for accurate diagnosis.

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    Area of Science:

    • Gastroenterology
    • Hereditary Diseases
    • Pancreatic Diseases

    Background:

    • Chronic pancreatitis can lead to pancreatic ascites, a rare complication.
    • Hereditary pancreatitis is an inherited condition affecting the pancreas.
    • Diagnostic delays can result in invasive procedures and increased patient morbidity.

    Observation:

    • An adolescent female presented with massive, painless ascites.
    • Initial diagnostic workup for ascites excluded pancreatic enzyme levels.
    • A ductal fistula secondary to chronic pancreatitis was identified.
    • Asymptomatic relatives showed pancreatic abnormalities, suggesting a hereditary basis.

    Findings:

    • The patient's condition was attributed to hereditary pancreatitis presenting as pancreatic ascites.
    • Delayed diagnosis occurred due to the omission of serum and ascitic amylase measurements.
    • An unnecessary laparotomy was performed before the correct diagnosis.

    Implications:

    • This case highlights a previously undescribed presentation of hereditary pancreatitis.
    • Emphasizes the importance of measuring serum and ascitic amylase in evaluating ascites.
    • Suggests considering hereditary pancreatitis in cases of unexplained pancreatic ascites, especially with family history.

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