An 82-year-old woman came to our emergency room due to sudden-onset abdominal pain in the epigastrium. On examination, the patient presented hypotension and anuria. The abdomen was distended with widespread pain upon palpation, guarding and signs of peritoneal irritation. Laboratory tests showed leukocytosis and serum amylase 681. On the CT scan, we observed pneumoperitoneum located in the root of the mesentery extending to the gastrohepatic ligament, gall bladder region and retroperitoneum (Figs. 1 and 2). Emergency surgery revealed free serosanguinous fluid, diffuse steatonecrosis and destructured pancreas, with no evidence of visceral perforation. Cholecystectomy was performed, and a pancreatic drain was inserted. The patient developed refractory multiple organ failure and died 48h after hospitalization.
Please cite this article as: Romera Barba E, Torregrosa Pérez N, García Marcilla JA, Vázquez Rojas JL. Pancreatitis aguda enfisematosa. Cir Esp. 2014;92:e1.