Ascitesis a rare complication of chronic pancreatitis.
Clinical and laboratory features:
(1) chronic pancreatitis, often with pseudocyst or a pancreatic duct fistula
(2) elevated ascitic fluid amylase (> 1,000 IU/L)
(3) variable elevation of neutrophils (often > 250 per µL)
(4) exclusion of other explanations for the ascites.
Differential diagnosis:
(1) pancreatitis in a patient with cirrhosis
(2) spontaneous bacterial peritonitis
Management may include:
(1) NPO with parenteral nutrition
(2) repeated paracentesis
(3) ERCP with stent
(4) octreotide or somatostatin therapy (to reduce pancreatic secretions)
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Specialty: Gastroenterology
