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Digestive diseases and sciences
06, 2022;67 (6): 1987-1993.

Ascites in Acute Pancreatitis: Clinical Implications and Management.

Nikhil Bush, Surinder Singh Rana
Author Information
  1. Nikhil Bush: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
  2. Surinder Singh Rana: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. drsurinderrana@yahoo.co.in.
PMID: 34036465 DOI: 10.1007/s10620-021-07063-6

Abstract

Clinically significant ascites in acute pancreatitis (AP) is rarely encountered and is a result of multifactorial pathogenesis. Early reactionary ascites in AP usually does not require any treatment and resolves spontaneously in majority of patients. A diagnostic analysis should be performed in case of ascites developing in the latter stages with increasing pain or worsening organ failure. Low serum albumin-ascites gradient ascites with amylase > 1000 U/l is highly suggestive of pancreatic ascites that is usually associated with duct disruption. A combination of nasojejunal feeding, subcutaneous octreotide, endoscopic drainage and rarely, surgery are employed in managing this difficult to treat condition. There is a need of further studies to better understand the clinical role of ascites as well as contribution of other factors like hypoalbuminemia and portal hypertension to its development in AP.

Keywords

Acute pancreatitis Amylase Ascites Duct disruption Pancreatic duct

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MeSH Term

Acute Disease
Amylases
Ascites
Humans
Pancreatic Diseases
Pancreatitis

Chemicals

Amylases
Journal Article Review
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Word Cloud

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