Pancreatic ascites: A rare complication of necrotizing pancreatitis: A case report and review of the literature

Petra Johst, Gregory G. Tsiotos, Michael G. Sarr

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

We describe a young patient with a family history of hereditary pancreatitis who developed extensive pancreatic necrosis complicated by pancreatic ascites. Because of failure of medical management, he was successfully treated with operative necrosectomy and primary wound closure over peripancreatic drains. A postoperative low-output pancreaticocutaneous fistula resolved with time. Pancreatic ascites, as a result of pancreatic duct disruption, is more common in chronic rather than acute pancreatitis and is exceedingly uncommon in the context of necrotizing pancreatitis. When it complicates the latter, treatment should be guided by the principles of management of necrotizing pancreatitis. However, when true pancreatic ascites persists, the pancreatic duct anatomy and site of leak should be defined with endoscopic retrograde pancreatography (ERP). Treatment options include endoscopic duct dilatation and stent placement (if a stricture exists proximal to the leak), onlay pancreaticojejunostomy, or distal pancreatectomy (especially if the leak is located in the distal pancreas or in an enterically isolated distal pancreas).

Original languageEnglish (US)
Pages (from-to)151-154
Number of pages4
JournalInternational Journal of Pancreatology
Volume22
Issue number2
StatePublished - 1997

Keywords

  • Necrosectomy
  • Necrotizing pancreatitis
  • Pancreatic ascites
  • Pancreatic fistula

ASJC Scopus subject areas

  • Oncology
  • Endocrinology
  • Gastroenterology

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