Pancreatic ascites in childhood

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Pancreatology

Background:

• Pancreatic ascites in pediatric patients is an exceptionally rare condition.
• While often associated with trauma, its etiology can be idiopathic.
• Chronic pseudocysts represent a potential, albeit infrequent, cause.

Purpose of the Study:

• To report a rare case of massive pancreatic ascites in a pediatric patient.
• To describe the diagnostic and therapeutic approach for pancreatic ascites secondary to a chronic pseudocyst.
• To highlight surgical management strategies for complex pancreatic ductal issues.

Main Methods:

• Case report of a 15-year-old female with massive pancreatic ascites.
• Diagnostic workup to identify the source of fluid leakage.
• Surgical treatment involving pseudocyst resection, distal pancreatectomy, and Roux-en-Y pancreaticojejunostomy for ductal drainage.

Main Results:

• Successful identification and management of a leaking chronic pancreatic pseudocyst.
• Resolution of massive pancreatic ascites following surgical intervention.
• Effective retrograde drainage of the dilated pancreatic ductal system was achieved.

Conclusions:

• Surgical management, including pseudocyst resection and pancreaticojejunostomy, is effective for pediatric pancreatic ascites from pseudocysts.
• This case underscores the importance of considering non-traumatic causes of pancreatic ascites in children.
• Roux-en-Y pancreaticojejunostomy provides a viable option for managing complex ductal anatomy in such cases.