Pancreatic ascites: management by caudal pancreatectomy and side-to-side pancreaticojejunostomy.

A patient with pancreatic ascites is presented who had neither a pseudocyst nor demonstrable pancreatic duct disruption, despite the presence of both calculi and strictures in a dilated duct of Wirsung. Concurrently, the patient exhibited intractable abdominal pain characteristic of end-stage chronic alcoholic pancreatitis. The pancreatic ascites responded only briefly to nonoperative management with hyperalimentation. Side-to-side pancreticojejunostomy with caudal pancreatectomy relieved the patient of both pain and ascites, suggesting that this more direct approach may be worthy of consideration in patients with similar findings.