PANCREATIC ASCITES - MANAGEMENT BY CAUDAL PANCREATECTOMY AND SIDE-TO-SIDE PANCREATICOJEJUNOSTOMY

A patient with pancreatic ascites is presented who had neither a pseudocyst nor demonstrable pancreatic duct disruption, despite the presence of both calculi and strictures in a dilated duct of Wirsung. Concurrently, the patient exhibited intractable abdominal pain characteristic of end-stage chronic alcoholic pancreatitis. The pancreatic ascites responded only briefly to nonoperative management with hyperalimentation. Side-to-side pancreticojejunostomy with caudal pancreatectomy relieved the patient of both pain and ascites, suggesting that this more direct approach may be worthy of consideration in patients with similar findings. © 1979.