November 12, 2014
Notes: Yang, Li-Juan
Research Support, Non-U.S. Gov’t
Hepatobiliary Pancreat Dis Int. 2013 Aug;12(4):428-35.
Author Address: Department of Gastroenterology, and Shanghai Key Laboratory of Pancreatic Diseases, Shanghai First People’s Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
Reference Type: Journal Article
Record Number: 4963Author: Yasuda, T., Kamei, K., Araki, M., Nakata, Y., Ishikawa, H., Yamazaki, M., Sakamoto, H., Kitano, M., Nakai, T. and Takeyama, Y.
Title: Extraperitoneal Fluid Collection due to Chronic Pancreatitis
Journal: Case Rep Gastroenterol
Short Title: Extraperitoneal Fluid Collection due to Chronic Pancreatitis
Alternate Journal: Case reports in gastroenterology
ISSN: 1662-0631 (Electronic)
Accession Number: 24019764
Abstract: A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy) was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl) was found to exist in the extraperitoneal space (over the peritoneum), but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.