Black Ascites: An interesting presentation of pancreatic duct leak

Introduction: Common causes of ascites include liver cirrhosis, heart failure, and malignancy. Pancreatic etiology is less common for ascites, but is most often a result of chronic pancreatitis secondary to alcoholic liver damage or pancreatic duct leak. Case description: The following case describes a patient with black-colored ascites secondary to pancreatic duct leak after total colectomy with ileorectal anastomosis. The colectomy was indicated by MYH-positive polyposis, and the there was no known prior liver or pancreas disease. Management included pancreatic duct stent placement, and drains from the pancreatic tail. Discussion: Pancreatic etiology is rare among ascites diagnoses; this case is even rarer due to gross appearance of the ascitic fluid and its iatrogenic cause.