Pancreatic ascites: treatment with octreotide – Case report <b>[Abstract in English]</b>

Abstract

Introduction: Pancreatic ascites is a rare condition, with less than 250 cases published. It is defined as exsudative ascites caused by a nonmalignant pancreatic disease with diagnostic labarotial characteristics high concentrations of amylase (generally > 1.000 UI/L) and protein (> 3.0 g/dl) in the ascitic liquid. The objective of this study is to describe the evolution of a case of pancreatic ascites focusing on the treatment proposed.
Description of the case: The patient was a 37-yearold male with a previous diagnose of chronic pancreatitis. When hospitalized, his complaint was abdominal pain. In the physical exam, he presented ascites, which was punctured, evidencing total proteins 4.2 g/dl and amylase 11.457 UI/L. The treatment for pancreatic ascites started with the administration of total parenteral nutrition and octreotide, the latter being maintained for 28 days. The patient had a progressive reduction of the ascites and did not present abdominal pain. During the 3 and 6 months in which he participated in clinical follow ups, he was asymptomatic.
Comments: The treatment of pancreatic ascites is still controversial. It can be conservative or interventional, and the latter can either be endoscopic or surgical. Despite the success of the treatment with octreotide in the case reported, and considering the few and controversial evidences presented in the literature, more patients should be observed in order to determine the best treatment for pancreatic ascites.
KEY WORDS: ASCITES/drug therapy; PANCREAS; OCTREOTIDE.