Chronic pancreatitis with extra peritoneal fluid collection
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Chronic pancreatitis is an inflammatory condition that causes permanent structural changes with impairment of the endocrine and exocrine functions of the pancreas. Clinical manifestations of this disorder include chronic abdominal pain and pancreatic dysfunction, which may not be clinically evident until a large portion of the pancreas is affected. It is associated with a multitude of complications, most commonly being pseudocyst formation. Rarely, it causes pancreatic ascites or pleural effusion. We report a case of a man who was initially presumed and treated as alcoholic chronic liver disease (CLD) with ascites but eventually confirmed having chronic pancreatitis and fluid in the extraperitoneum.

Clinical presentation
A 30 year old male, with a longstanding history of chronic alcoholic consumption was admitted to our medical ward with recurrent episodes of abdominal distension. He had multiple admissions for which therapeutic and diagnostic peritoneal tapping were done. He was initially treated as alcoholic CLD Child- Pugh B. Despite having recurrent admissions and treated as decompensated alcoholic CLD with spontaneous bacterial peritonitis, his peritoneal fluid cultures and cytology were negative and medical therapy for CLD failed to improve his symptoms. We proceeded with Computed Tomography Abdomen and showed a large collection of fluid in the extraperitoneum with mild ascites. Mild hepatomegaly, with a hypodense lesion at the pancreatic body was present.