In 22 patients the fistula was into the peritoneal cavity and they presented with pancreatic ascits. In 7 patients the fistula tracked up through the mediastinum into a pleural cavity, and they presented with pancreatic pleural effusions. [ncbi.nlm.nih.gov]

Presentation These patients present with increased abdominal girth, weight loss, variable abdominal pain, and possibly shortness of breath if the fluid compresses the diaphragm or enters transdiaphragmatic channels resulting in concomitant high amylase [slideshare.net]

• Overeating

  Abstract Thirty-four patients seen over a 10-year period with internal pancreatic fistulas are reported. In 22 patients the fistula was into the peritoneal cavity and they presented with pancreatic ascits. [ncbi.nlm.nih.gov]

  The authors reviewed 265 cases of pancreatitis over a 5-yr period. There were 129 blacks and 136 Caucasians. Ages ranged from 19-86 yr, with a mean of 46.2 yr. Eight of these cases (3%) were found to have pancreatic ascites. [ucdavis.pure.elsevier.com]

  Twenty-six (92.8%) patients had complete resolution of ascites/effusion over a median 5 weeks. The stents were removed 3–6 weeks later without any recurrence over the next 6–36 (median = 17) months. [eprints.manipal.edu]

• Anger

  O'Toole Service de gastroentérologie, CHU d'Angers, 4, rue Larrey, 49933 Angers Cedex 9. [email protected] @@#[email protected]@ Les fistules pancréatiques au cours de la pancréatite chronique: diagnostic non invasif et stratégie thérapeutique Le diagnostic [em-consulte.com]

It is suggested that the clinical entity of pancreatic ascites occurs more often than reported and a workup for it should be done even in the face of unconvincing radiographic and angiographic evidence. [ncbi.nlm.nih.gov]

• Pleural Exudate

  Diagnosis of the internal pancreatic fistula was based on the findings of high amylase levels and elevated albumin content of the peritoneal and pleural exudates. Failure of medical therapy was the indication of surgical treatment in all patients. [ncbi.nlm.nih.gov]

Conservative therapy is the most common initial treatment option but has high failure rates hence arguing for interventional therapy as a preferred primary treatment option. [ncbi.nlm.nih.gov]

However, treatment failure may occur in 33-50% of patients [ 16 ]. The treatment of MPD ruptures with high output pancreatic serous effusions may be different. [em-consulte.com]

When the conditions has been diagnosed the prognosis is surprisingly good despite the poor presenting condition of most patients. [ncbi.nlm.nih.gov]

Prognosis The prognosis depends upon the condition that is causing the ascites. Carcinomatous ascites has a very bad prognosis. However, salt restriction and diuretics can control ascites caused by liver disease in many cases. [encyclopedia.com]

ERCP demonstrated a pseudocyst and the site of disruption of the pancreatic duct, but not the etiology of the pancreatitis. Following a period of nutritional support, surgery was carried out. [ncbi.nlm.nih.gov]

[…] role of endoscopic retrograde cholangiopancreatography (ERCP) in the setting of acute pancreatitis has primarily been twofold. 1 First, it has been used after resolution of an acute attack, or more commonly multiple attacks, in an attempt to define etiology [abdominalkey.com]

Epidemiology of Ductal Disruption If the underlying pathophysiology of acute pancreatitis is colocalization of zymogen granules with cell membranes, setting off an inflammatory cascade with local effects related to cytokine release and recruitment of [abdominalkey.com]

Stimac D, Mikolasevic I, Krznaric-Zrnic I, et al ; Epidemiology of Acute Pancreatitis in the North Adriatic Region of Croatia during the Last Ten Years. Gastroenterol Res Pract. 20132013:956149. doi: 10.1155/2013/956149. Epub 2013 Feb 14. [patient.info]

Discussion The incidence of chylous ascites in developed countries is approximately one case per 20,000 admissions, although large epidemiological studies are lacking. 1 Among known causes of chylous ascites there are many pathological processes such [scielo.isciii.es]

So careful comparative analysis of peritoneal exudate, plasma and lymph with regards to putative mediators of local and remote injury may provide essential pathophysiological clues. [ncbi.nlm.nih.gov]

References: [1] [12] [13] Complications Pancreatic pseudocysts Definition : encapsulated collection of pancreatic fluid ; which develops 4 weeks after an acute attack of pancreatitis ; can occur in both acute and chronic pancreatitis Pathophysiology : [amboss.com]

"Ascites fluid in severe acute pancreatitis: from pathophysiology to therapy". Acta Gastroenterol Belg. 63 (3): 264–8. PMID 11189983. Iacono C, Procacci C, Frigo F, Andreis IA, Cesaro G, Caia S, Bassi C, Pederzoli P, Serio G, Dagradi A (1989). [en.wikipedia.org]

Pathophysiology of ascites Increased portal venous pressure ( The pathophysiology of ascites due to cirrhosis. ) Any cause of increased resistance to hepatic or portal venous blood flow can lead to ascites. [surgwiki.com]

Epidemiology of Ductal Disruption If the underlying pathophysiology of acute pancreatitis is colocalization of zymogen granules with cell membranes, setting off an inflammatory cascade with local effects related to cytokine release and recruitment of [abdominalkey.com]

Suggestions for Ascites In order to prevent the development of ascites, it is important to prevent the risk factors that lead to the disease. These precautions can help to prevent Ascites: Avoiding alcohol can prevent liver disease and cirrhosis. [home-remedies-for-you.com]

Prevention Modifying or restricting use of salt can prevent most cases of recurrent ascites. Resources BOOKS Berkow, Robert, editor. The Merck Manual of Medical Information. Whitehouse Station, NJ: Merck Research Laboratories, 1997. [encyclopedia.com]

Can ascites be prevented? The prevention of ascites largely involves preventing the risk factors of the underlying conditions leading to ascites. [medicinenet.com]