A CASE OF PANCREATIC ASCITES

Abstract

Massive and chronic ascites due to a non-malignant pancreatic disease is recognized as pancreatic ascites. The diagnosis is made by demonstrating increased protein content and high amylase level in the ascitic fluid. A case of pancreatic ascites is reported and 27 cases of this disease in Japan are reviewed. The patient, as 63-year-old man, was admitted to our hospital with the chief complaint of severe abdominal distension. There was a long history of ethanol abuse. The diagnosis of pancreatic ascites was established on the basis of elevatd levels of serum amylase (2304IU/l), ascitic fluid amylase (6300IU/l), ascitic fluid protein (3.4g/dl). One month after his adminission, massive ascites and a pancreatic psuedocyst were detected by computed tomography and ultrasonography. A endoscopic retrograde pancreatogram and percutaneous cystogram revealed no communication between the pancreatic duct and the cyst, nor did contrast media leak into the peritoneal cavity. The patient was treated with hyperalimentaion, parasentesis, etc., but the ascites did-not resolve after 4 weeks of medical treatment. Cystogastrostomy was performed on 24/11/1985. The ascites and high amylasanemia resolved completely soon after the operation. there was no recurrence over a period of sixteen months.