This was a case of pancreatic ascites proven by elevated amylase in the ascitic fluid. This patient was managed medically safely by large-volume paracentesis. He is doing well and free of ascites 2 years later.

Pancreatic ascites is usually due to disruption of the pancreatic duct, but as this case shows, one can get pancreatic ascites from severe pancreatitis without duct disruption and resolution is possible with conservative management.