Pancreatic ascites consists in the presence of pancreatic juice into the peritoneal cavity, coming from pseudocysts or pancreatic ducts breaches, that produce the accumulation of an exudate rich in proteins and amylase; these findings certify the diagnosis.

We report a case of pancreatic ascites with pleural effusion:

alcoholic patient, without previous episodes of acute pancreatitis, with ascites, weight loss, abdominal pain, right pleural effusion, insidious onset, blood level of amylase: more than 1024 UD; CT: ascites, right pleural effusion, pseudocyst in the head (24 mm) and in the tail (77 mm) of the pancreas.

Treatment:

a transgastric cystogastrostomy in the cyst of 8 cm and a transduodenal punction in the cyst of 3 cm were performed, with an excellent postoperative result.