Abstract ACCUMULATION of fluid in the peritoneal cavity may occur in a variety of pancreatic lesions. In approximately 10% of patients with carcinoma of the pancreas, for example, ascites may develop. This usually indicates widespread peritoneal metastases. Some accumulation of peritoneal fluid is common in patients who die from severe forms of chronic pancreatitis. In general, however, ascites is unusual with reversible, chronic pancreatic disease. A pseudocyst of the pancreas is seldom considered in the differential diagnosis of massive ascites. Although case reports have occurred in the literature, this association has received no attention in the surgical literature. In fact, a few years ago a review of 150 collected cases disclosed only one patient in whom ascites was mentioned as a clinical feature.1 The authors have observed four patients in whom ascites was associated with pseudocysts of the pancreas and in whom the association appears to be specifically related, and References 1. Howard, J.M., and Jordan, G.L., Jr.: Surgical Diseases of the Pancreas , Philadelphia: J. B. Lippincott Co., Inc., 1960. 2. Morris, G.C.: Personal communication to the author. 3. Barua, R.L.; Villa, F.; and Steigmann, F.: Massive Ascites Due to Pancreatitis , Amer J Dig Dis 7:900-906, 1962.Crossref 4. Anacker, Von H.; Linden, G.; and Humpert, R.: Die chronischen Pankreaskrankheiten in Splenoportogramm , Fortschr Roentgen 99:129-143, 1963.Crossref 5. Snider, H.R., and Nelson, M.C.: Portal Hypertension With Hemorrhage From Esophageal Varices Secondary to Acute Recurrent Pancreatitis , Surgery 40:1065-1068, 1956. 6. McDermott, W.V., Jr.: Portal Hypertension Secondary to Pancreatic Disease , Ann Surg 152: 147-150, 1960.Crossref 7. Bockus, H.L.: Gastroenterology , Philadelphia and London: W. B. Saunders Co., 1946, vol 3, p 840.
Archives of Surgery – American Medical Association
Published: Aug 1, 1966