Concomitant fungal peritonitis and high ascitic amylase as a rare manifestation of gastric perforation. Issue 3 (29th March 2019)

• Record Type: Journal Article
• Authors: Alasadi, Lugien; Alsuliman, Tamim; Alkabbani, Nawara; Mulhem, Siba; Jomaa, Anas; Wassouf, Ahmad
• Is Part Of: Oxford medical case reports. Volume 2019:Issue 3(2019)
• Publication Date: 2019-03-29
• Subjects: Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1093/omcr/omz022
• Languages: English
• ISSNs: 2053-8855

Abstract

Abstract: High ascitic amylase concentration has been reported to be a characteristic of pancreatic ascites. However, values greater than 2000 U/l can also be seen in intestinal perforation. Fungal peritonitis is a serious entity that could also be caused by hollow viscous perforation. Herein we report a 22-year-old woman with epigastric pain, imitating an acute pancreatitis, and abdominal distention. Laboratory and radiological investigations revealed a high ascitic Amylase level with secondary fungal peritonitis due to gastric ulcer perforation. This case highlights the importance of careful clinical evaluation and a multi-disciplines approach in patients with high ascitic Amylase levels especially in limited-resources areas in order not to miss a diagnosis in which a surgical approach can be lifesaving. To the best of our knowledge, this is the first reported case of concomitant very high ascetic Amylase level and fungal peritonitis as a manifestation of gastric perforation.