A 42 year old man has recurrent duodenal ulceration with bleeding despite omeprazole therapy use. H. pylori serology has been negative on three occasions. An abnormality is noticed on imaging of his pancreas. What other health problems might this man have?

This man gives a history of acute pancreatitis, probably secondary to alcohol, and now presents with ascites. His liver function tests show a normal liver synthetic function (bilirubin and INR), which makes portal hypertension due to chronic liver disease an unlikely cause of the ascites. Ruptured pancreatic pseudocyst is a recognised complication of acute pancreatitis and leads to an elevated ascitic fluid amylase.