Abstract
A 76-year-old man without an apparent history of chronic pancreatitis was admitted because of massive ascites. The pancreas was normal in abdominal CT scan but pancreatic enzymes in ascites and serum were elevated. The patient was treated by the conservative therapy, and endoscopic retrograde pancreatography (ERP) which performed after ascites disappeared showed the small cystic lesion with leakage of contrast medium into the peritoneal cavity, so that the patient was diagnosed as pancreatic ascites due to disruption of the cystic lesion. Pancreatic ascites has become recognized as a complication of chronic pancreatitis and diagnosed as evidence of internal pancreatic fistula. ERP does not always demonstrate internal pancreatic fistula and there are possible complications associated with ERP, which include recurrence of pancreatic ascites. In this case, the patient has no apparent history of chronic pancreatitis and pancreatic ascites did not recur after ERP.
