title: Chronic pancreatitis associated with chylous ascites simulating liver cirrhosis.
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.
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Wellington
authors.initials: W
authors.lastname: Andraus
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Lucas Souto
authors.initials: LS
authors.lastname: Nacif
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Raphael L C
authors.initials: RL
authors.lastname: Araujo
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Yuri Dos Santos
authors.initials: Ydos S
authors.lastname: Buscariolli
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Mayara
authors.initials: M
authors.lastname: Salvato
authors.affiliation: Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, 05403-900 São Paulo, SP, Brazil.
authors.forename: Luiz Augusto Carneiro
authors.initials: LA
authors.lastname: D'Albuquerque