Why we have ascitis and pleural effusion in Pancreatitis! - USMLE Forums
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Old 05-29-2011
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Pancreas Why we have ascitis and pleural effusion in Pancreatitis!

Question: Why is the complication of pancreatitis as ascitis and pleural effusion with increased amount of amylase, what's the pathogenesis?

Answer: Pancreatic ascites develops when fluid leaks from a disrupted pancreatic duct into the peritoneal cavity. Leakage into the thoracic cavity can result in a pleural effusion or a pleuro-pancreatic fistula!

Ref: Davidson's Principles and Practice of Medicine
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Old 05-31-2011
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Yes but why does it leak from the pancreatic duct into the peritoneal or thoracic cavity? How does it get into the thoracic cavity anyway? The pancreatic duct is congruous with the duodenum, not the thorax...
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Old 05-31-2011
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Quote:
Originally Posted by karansaraf View Post
Yes but why does it leak from the pancreatic duct into the peritoneal or thoracic cavity? How does it get into the thoracic cavity anyway? The pancreatic duct is congruous with the duodenum, not the thorax...
we must remember that the pancreas has the strongest proteolytic enzymes such as typsin chymotryspsin etc ( which are thank god. in the inactive form in the pancreas) - however prolonged standing due to obstruction and fibrosis activates proteolytic enzymes within the pancreas thus leading to the leakage outside .. trypsin can digest through pretty much anything....

hope this helps
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Old 06-04-2011
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Quote:
Originally Posted by drarnab View Post
we must remember that the pancreas has the strongest proteolytic enzymes such as typsin chymotryspsin etc ( which are thank god. in the inactive form in the pancreas) - however prolonged standing due to obstruction and fibrosis activates proteolytic enzymes within the pancreas thus leading to the leakage outside .. trypsin can digest through pretty much anything....

hope this helps

Better think that pleural effusions are due to SIRS - sistemic inflamatory response.
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