pancreatic ascites

Etiology

• pancreatic pseudocyst leakage (most common)
• pancreatic duct rupture

Clinical manifestations

• abdominal pain may be present
• may present surreptitiously after an episode of mild pain
• pleural effusion may occur

Laboratory

• ascitic fluid analysis
  • amylase
  • WBC count, RBC count, protein, cytology
  • culture for acid-fast bacteria
• endoscopic retrograde cholangiopancreatography (ERCP)

Radiology

• computed tomography with special cuts of pancreas

Management

• nothing by mouth
• parenteral nutrition for 2-3 weeks
• octreotide 100-200 ug IV TID to inhibit pancreatic secretion
• failure to respond to 2-3 weeks of conservative management
  • ERCP
  • endoscopic placement of a stent across area of leak
  • surgical resection proximal to disrupted duct

More general terms

• ascites