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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/284: 100-102 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/284: 100-102

Title: A case of acute pancreatitis – does step-up protocol always indicated? 

Authors: Burek J, Jaworska K, Witkowski G, Durlik M. 

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A case of acute pancreatitis – does step-up protocol always indicated?


Burek J1, Jaworska K1, Witkowski G2,3, Durlik M2,3.

1Medical Faculty, Medical University of Warsaw, Warsaw, Poland; 2Department of Gastroenterological Surgery and Transplantation, Central Hospital of Ministry of Internal Affairs and Administration in Warsaw, Poland; 3Medical Center for Postgraduate Education, Warsaw, Poland

Acute pancreatitis (AP) is still one of the most frequent cause of hospitalization. Grading severity of AP due to revised Atlanta classification differentiate: mild, moderately severe and severe AP. Mortality ranges from occasional tomild, 8% in moderate, 36%-59% in severe AP.
A case report
. 59-year-old man was hospitalized due to severe acute pancreatitis. Biliary duct obstruction was determined as a reason of AP and intensive treatment was started. The CT scan showed infected post-inflammatory pancreatic cyst. For this reason, endoscopic drainage of the pancreatic cyst to the stomach was performed first and then Jurasz operation. Severe postoperative course required treatment in the Intensive Care Unit (ICU). During the next hospitalization due to the patient’s condition deterioration, endoscopic cyst drainage was performed again. Because of ineffectiveness of the performed treatment, the patient was reoperated. Post-operative multi-organ failure, lack of response to the intensive therapy and cachexia because of long-lasting illness, lead into patient’s death.
Conclusions
. This case demonstrates problem with severe complications of AP which despite of multidisciplinary treatment combining endoscopy, surgery and pharmacology can finally lead to death.

Key words: acute pancreatitis, endoscopy, surgery

Pol Med J, 2020; XLVIII (284); 100–102