What is pancreatic ascites?

Pancreatic ascites refers to fluid that builds up in the abdomen that is related to a dysfunctional pancreas. Analysis of pancreatic ascitic fluid usually reveals a high level of amylase and high levels of protein. The abdomen affected by ascites appears distended and there is often an increase in abdominal circumference. Severe pain is usually absent, however, weight loss may occur, despite the appearance of a large abdomen. This condition is more common in men, and usually appears between the ages of 20 and 50.

Typically, a past history of pancreatitis is usually present, and alcohol consumption is also common in patients suffering from pancreatic ascites. Diagnosis to rule out underlying causes of pancreatic ascites includes a complete physical exam and complete medical history. Physical examination will often reveal abdominal distention, changing opacity, and flank opacity. Medical imaging tests may reveal fluid in the abdomen, pancreatic calcifications, and pseudocysts.

Treatment options for pancreatic ascites include conservative treatment or surgical intervention. In general, conservative options include giving parenteral nutrition and draining excess fluid. Surgery for the problem may include repair of the fluid leak and management of pancreatic pathology, such as strictures and pseudocysts. Sometimes the use of a pancreatic stent will be beneficial. These stents allow secretions to flow through the system created by the stent, sealing the leak.

It is important to note that ascites or fluid in the peritoneal cavity can be caused by medical conditions other than a diseased pancreas. Certain peritoneal cancers, such as ovarian cancer, can cause significant fluid buildup, as can certain liver disorders. Cirrhosis of the liver can sometimes cause ascites, however, cirrhosis usually causes other symptoms such as jaundice, which is a yellowing of the skin and eyes, nausea, and pain.

When pancreatic ascites is present, it is important to treat the underlying cause of the fluid buildup. In cases where pancreatitis is present, steps should be taken to reduce the primary symptoms, such as pain, nausea, and vomiting. When symptomatic relief is obtained, the patient can better tolerate the actual treatment of pancreatic ascites. In general, treating fluid buildup without treating the underlying cause can weaken the patient and suppress their immune system.

People who begin to notice an increase in abdominal girth, along with bloating, should immediately seek medical evaluation. Failure to receive a definitive diagnosis and subsequent treatment could delay resolution of this condition and contribute to complications such as shortness of breath. Shortness of breath and labored breathing can be significant as fluid builds up in the abdominal cavity, putting pressure on other structures, including the diaphragm.

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