{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:55:22Z","timestamp":1779897322139,"version":"3.53.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Pancreatic ascites refers to the massive accumulation of pancreatic fluid in the peritoneal cavity and is a rare entity. Chronic alcoholic pancreatitis is the most common cause. Ascites is commonly seen in patients with alcoholic liver disease and is usually a consequence of portal hypertension. Biliary pancreatitis, pancreatic trauma and cystic duplications of biliopancreatic ducts, ampullary stenosis, or ductal lithiasis are the remaining causes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 53-year-old\u00a0Chhetri man, a chronic alcoholic, presented with epigastric pain and abdominal distension. He had made several previous visits to a local hospital within the past 6 months for a similar presentation. Serum alkaline phosphatase 248\u2009IU\/L, serum amylase 1301\u2009IU\/L, and lipase 1311\u2009IU\/L were elevated while serum calcium was decreased (1.5\u2009mmol\/l). Ascitic fluid amylase was elevated (2801\u2009IU\/L). A computed tomography scan of his abdomen revealed features suggestive of acute-on-chronic pancreatitis. The case was managed with a conservative approach withholding oral feedings, starting total parenteral nutrition, paracentesis, octreotide, and pigtail drainage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Pancreatic ascites is a rare entity. Diagnosis is suspected with raised ascitic fluid amylase in the presence of pancreatic disease. Such cases can be managed by conservative approach or interventional approach. We managed this case through a conservative approach.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-020-02463-0","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T23:06:40Z","timestamp":1600124800000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pancreatic ascites managed with a conservative approach: a case report"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0692-1786","authenticated-orcid":false,"given":"Raju","family":"Bhandari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajan","family":"Chamlagain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saraswati","family":"Bhattarai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric H.","family":"Tischler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Mandal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh Singh","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"issue":"41","key":"2463_CR1","doi-asserted-by":"publisher","first-page":"11522","DOI":"10.3748\/wjg.v21.i41.11522","volume":"21","author":"M Mart\u00ednez-Esparza","year":"2015","unstructured":"Mart\u00ednez-Esparza M, Trist\u00e1n-Manzano M, Ruiz-Alcaraz AJ, Garc\u00eda-Pe\u00f1arrubia P. Inflammatory status in human hepatic cirrhosis. World J Gastroenterol. 2015;21(41):11522\u201341. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26556984.","journal-title":"World J Gastroenterol"},{"key":"2463_CR2","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/978-3-642-75319-0_34","volume-title":"Chronic Pancreatitis","author":"JP Neoptolemos","year":"1990","unstructured":"Neoptolemos JP, Winslet MC. Pancreatic Ascites. In: Beger HG, B\u00fcchler M, Ditschuneit H, Malfertheiner P, editors. Chronic Pancreatitis. Berlin, Heidelberg: Springer Berlin Heidelberg; 1990. p. 269\u201379."},{"issue":"6","key":"2463_CR3","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1097\/00000658-197612000-00013","volume":"184","author":"EL Bradley","year":"1976","unstructured":"Bradley EL, Gonzalez AC, Clements JL Jr. Acute pancreatic pseudocysts: incidence and implications. Ann Surg. 1976;184(6):734\u20137. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/999349.","journal-title":"Ann Surg"},{"issue":"1","key":"2463_CR4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1177\/0049475515585617","volume":"46","author":"SK Nayak","year":"2015","unstructured":"Nayak SK, Gaadhe RL, Piramanayagam P, Palaniswamy KR. A young man with skin rash and ascites. Trop Doct. 2015;46(1):60\u20131. https:\/\/doi.org\/10.1177\/0049475515585617.","journal-title":"Trop Doct"},{"issue":"6","key":"2463_CR5","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1067\/mge.2003.221","volume":"57","author":"DK Bhasin","year":"2003","unstructured":"Bhasin DK, Malhi NS, Nagi B, Singh K. Pancreatic ascites treated by endoscopic pancreatic sphincterotomy alone: A case report. Gastrointest Endosc. 2003;57(6):802\u20134. https:\/\/doi.org\/10.1067\/mge.2003.221.","journal-title":"Gastrointest Endosc"},{"key":"2463_CR6","doi-asserted-by":"crossref","unstructured":"He W-H, Xion Z-J, Zhu Y, Xia L, Zhu Y, Liu P, et al. Percutaneous Drainage Versus Peritoneal Lavage for Pancreatic Ascites in Severe Acute Pancreatitis: A Prospective Randomized Trial. Pancreas. 2019;48(3) Available from: https:\/\/journals.lww.com\/pancreasjournal\/Fulltext\/2019\/03000\/Percutaneous_Drainage_Versus_Peritoneal_Lavage_for.7.aspx.","DOI":"10.1097\/MPA.0000000000001251"},{"issue":"2)","key":"2463_CR7","first-page":"6","volume":"5","author":"S Gupta","year":"2017","unstructured":"Gupta S, Gaikwad N, Samarth A, Sawalakhe N, Sankalecha T. Efficacy of Pancreatic Endotherapy In Pancreatic Ascites And Pleural Effusion. Med Sci (Basel, Switzerland). 2017;5(2)):6. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29099022.","journal-title":"Med Sci (Basel, Switzerland)"},{"issue":"4","key":"2463_CR8","first-page":"245","volume":"2","author":"K Kanneganti","year":"2009","unstructured":"Kanneganti K, Srikakarlapudi S, Acharya B, Sindhaghatta V, Chilimuri S. Successful Management of Pancreatic Ascites with both Conservative Management and Pancreatic Duct Stenting. Gastroenterol Res. 2009;2(4):245\u20137. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27942284.","journal-title":"Gastroenterol Res"},{"issue":"5","key":"2463_CR9","first-page":"362","volume":"3","author":"RA Kozarek","year":"2007","unstructured":"Kozarek RA. Management of pancreatic ascites. Gastroenterol Hepatol (N Y). 2007;3(5):362\u20134. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/21960852.","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"7","key":"2463_CR10","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1111\/j.1440-1746.2009.05796.x","volume":"24","author":"CG Pai","year":"2009","unstructured":"Pai CG, Suvarna D, Bhat G. Endoscopic treatment as first-line therapy for pancreatic ascites and pleural effusion. J Gastroenterol Hepatol. 2009;24(7):1198\u2013202. https:\/\/doi.org\/10.1111\/j.1440-1746.2009.05796.x.","journal-title":"J Gastroenterol Hepatol"},{"issue":"2","key":"2463_CR11","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1148\/radiology.196.2.7617861","volume":"196","author":"JA Soto","year":"1995","unstructured":"Soto JA, Barish MA, Yucel EK, Clarke P, Siegenberg D, Chuttani R, et al. Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique. Radiology. 1995;196(2):459\u201364. https:\/\/doi.org\/10.1148\/radiology.196.2.7617861.","journal-title":"Radiology"},{"issue":"suppl 1","key":"2463_CR12","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1159\/000201078","volume":"54","author":"I Segal","year":"1993","unstructured":"Segal I, Parekh D, Lipscl\u00fctz J, Gecelter G, Myburgh Baragwanath JA, Hospitals J. Treatment of Pancreatic Ascites and External Pancreatic Fistulas with a Long-Acting Somatostatin Analogue (Sandostatin). Digestion. 1993;54(suppl 1):53\u20138.","journal-title":"Digestion"},{"issue":"2","key":"2463_CR13","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/0016-5085(83)90306-2","volume":"85","author":"P Par\u00e9","year":"1983","unstructured":"Par\u00e9 P, Talbot J, Hoefs JC. Serum-ascites albumin concentration gradient: A physiologic approach to the differential diagnosis of ascites. Gastroenterology. 1983;85(2):240\u20134.","journal-title":"Gastroenterology."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02463-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-020-02463-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02463-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T23:58:00Z","timestamp":1631663880000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-020-02463-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,15]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2463"],"URL":"https:\/\/doi.org\/10.1186\/s13256-020-02463-0","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,15]]},"assertion":[{"value":"1 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of this case report and accompanying images\u00a0was obtained from the patient. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None of the authors have any conflict of interest to disclose. We confirm that we have read the Journal\u2019s position on issues involved in ethical publication and affirm that this case report is consistent with those guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"154"}}