Management of pancreatic ascites complicating alcoholic chronic pancreatitis

•PA is a rare complication of alcoholic chronic pancreatitis (CP) that results in significant morbidity and mortality.•An initial morphological assessment is essential, particularly to determine the severity of the underlying pancreatitis and to obtain a precise topography of the lesion.•Conservative medical treatment seems to be ineffective and, if it fails, should be followed by a second-line endoscopic sphincterotomy±endoprosthesis insertion.•Surgery is a last-line treatment, but should be considered earlier if endoscopic treatment is not possible and in cases of associated necrotising pancreatitis.•Surgery is most often necessary for pancreatico-pleural effusion associated with PA.