Pancreatic Ascites

Excerpt

Pancreatic ascites is an intraperitoneal collection of pancreatic fluid primarily caused by persistent pancreatic duct leakage or the intraperitoneal rupture of a pancreatic pseudocyst. Pancreatic ascites is a complication of persistent chronic alcoholic pancreatitis. Less frequent etiologies of pancreatic ascites include biliary pancreatitis, major pancreatic duct trauma, ampullary stenosis, cystic ductal duplications, and choledocholithiasis. The severity of this condition varies widely, depending on the location and degree of ductal injury and if there's an infection. Mild cases resolve spontaneously, but infected or persistent pancreatic ascites and cases associated with adenocarcinoma of the pancreatic duct are associated with significant morbidity and mortality.

If conservative measures fail, a stent is recommended to bypass the damaged or leaking pancreatic duct. Adjunctive treatment includes medical management to decrease pancreatic exocrine secretions and salvage therapy with surgery. However, due to the low incidence of this condition, the results of comparative studies with different treatment approaches are unavailable.