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Pancreatic ascites

P Dhawan1, D N Amarapurkar, P Bhandarkar

  • 1Dept of Gastroenterology, BYL Nair Ch Hospital & TN Medical College, Bombay.

The Journal of the Association of Physicians of India
|September 1, 1993
PubMed
Summary

Pancreatic ascites is often missed, but high ascitic fluid amylase levels are diagnostic. Suspect pancreatic ascites in exudative ascites cases, especially in chronic alcoholics, and utilize laparoscopy for diagnosis.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Diagnostic Imaging

Background:

  • Pancreatic ascites is frequently overlooked in the differential diagnosis of exudative ascites.
  • A significant majority of pancreatic ascites cases are initially misdiagnosed.

Purpose of the Study:

  • To highlight the importance of considering pancreatic ascites in patients with exudative ascites.
  • To evaluate the diagnostic utility of ascitic fluid amylase levels and various investigations.

Main Methods:

  • Retrospective analysis of eleven cases of pancreatic ascites.
  • Assessment of clinical diagnoses, ascitic fluid analysis (amylase levels), Endoscopic Retrograde Pancreatography (ERP), and laparoscopy.

Main Results:

  • Exudative ascites with markedly elevated ascitic fluid amylase was observed in all patients.
  • Chronic alcoholism was a common predisposing factor (63.6%).
  • Laparoscopy accurately diagnosed pancreatic ascites in all cases and ruled out other conditions.

Conclusions:

  • Pancreatic ascites should be suspected in patients with exudative ascites, particularly chronic alcoholics.
  • Routine measurement of ascitic fluid amylase is crucial for diagnosis.
  • Endoscopic Retrograde Pancreatography (ERP) aids in identifying the leak site, while laparoscopy is invaluable for differential diagnosis.

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