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Case Reports in Surgery
Volume 2013, Article ID 763561, 3 pages
http://dx.doi.org/10.1155/2013/763561
Case Report

Chronic Pancreatitis Associated with Chylous Ascites Simulating Liver Cirrhosis

Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil

Received 10 July 2013; Accepted 9 October 2013

Academic Editors: O. Dalpiaz and M. Picchio

Copyright © 2013 Wellington Andraus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Ascites, esophageal varicose veins, and acute digestive bleeding are unusual in the clinical presentation of chronic pancreatitis; however, these symptoms are frequently observed in patients with liver cirrhosis. Moreover, it is unlikely to observe chylous ascites in both presentations. Method. We report a patient who presented with chronic pancreatitis with splenic vein thrombosis, necrosis of the pancreatic neck and tail, esophageal varicose veins with previous bleeding, and chylous ascites. After partial pancreatectomy, his treatment was based on low-fat oral diet with medium-chain triglycerides with remarkable resolution of the chylous ascites. After 3 years, he presented with decompensated chronic pancreatitis and underwent plexus alcoholization and biliary-enteric deviation with an unremarkable postoperative course. Conclusion. Ascites is rarely associated with chronic pancreatitis, and chylous ascites is even rarer. The treatment of atraumatic chylous ascites is based on resolution of the obstructive causes and should include drainage and a low-fat diet with medium-chain triglycerides.