Alanís Naranjo José Martín, de Lourdes Alanís Naranjo María
Department of Internal Medicine, Dr. Belisario Domínguez Hospital of Specialties, Mexico City, Mexico.
School of Medicine, Vasco de Quiroga University, Morelia, Mexico.
Oxf Med Case Reports. 2020 May 23;2020(4):omaa023. doi: 10.1093/omcr/omaa023. eCollection 2020 Apr.
The differential diagnosis for black ascites include pancreatic ascites (PA). In majority of cases described the ascitic fluid as amber or black-colored. We report the case of a 33-year-old man with a history of alcohol abuse who presented with 24 h of epigastric pain and abdominal distension. Laboratory results showed lipase of 1270 U/l, amylase of 442 U/l and albumin of 2 g/dl. A contrast computed tomography scan of the abdomen showed pancreatic necrosis with atrophy and free abdominal fluid. Paracentesis was performed, yielding opaque black ascitic fluid. An ascitic fluid analysis demonstrated amylase of 2769 U/l, albumin of 1.6 g/dl, was negative for malignant cells and tuberculosis. Serum-Ascites Albumin Gradient was resulted in 0.4. The diagnosis of chronic pancreatitis was suspected, and he received supportive care with pain medication and bowel rest. He was discharged with symptom free on Day 14 after admission.
黑色腹水的鉴别诊断包括胰源性腹水（PA）。在大多数已描述的病例中，腹水为琥珀色或黑色。我们报告一例33岁有酗酒史的男性，出现上腹部疼痛和腹胀24小时。实验室检查结果显示脂肪酶为1270 U/l，淀粉酶为442 U/l，白蛋白为2 g/dl。腹部增强计算机断层扫描显示胰腺坏死伴萎缩及腹腔游离液体。进行了腹腔穿刺，抽出不透明的黑色腹水。腹水分析显示淀粉酶为2769 U/l，白蛋白为1.6 g/dl，恶性细胞和结核菌素试验均为阴性。血清-腹水白蛋白梯度为0.4。怀疑为慢性胰腺炎，给予止痛药物和肠道休息等支持性治疗。入院后第14天症状消失出院。
