A Case of Pancreatic Ascites Successfully Treated with Peritoneal Lavage

A case of pancreatic ascites due to chronic pancreatitis is reported. A 39-year-old male, who had habitually drunk alcohol for the preceding 20 years, was admitted with acute abdominal distension and severe epigastralgia. Massive pancreatic ascites with liver cirrhosis and chronic pancreatitis were diagnosed by clinical and laboratory examinations. Peritoneal lavage was performed 19 days after the onset of his disease since conventional systemic treatment was without sufficient results. Two liters of lavage fluid containing 200 mg of gabexate mesilate, 100 mg of amicamycin and 2000 U of heparin were administered into the peritoneal cavity, retained for 60 minutes and allowed to drain spontaneously for the succeeding 120 minutes. Continuous peritoneal lavage was performed every 3 hours for 5 days. His clinical condition and the laboratory data including serum amylase levels were markedly improved remarkably by the treatment. Thus continuous peritoneal lavage using an isotonic fluid containing a protease inhibitor was useful for his recovery. However, there should be further investigation about the duration of lavage and the dose and type of protease inhibitor.