The patient was an 80-year-old obese woman who was admitted in the emergency room for acute gallstone pancreatitis. Twenty-four hours after admission, she presented symptoms of systemic sepsis and an abdominopelvic computed tomography (CT) scan was ordered (Figs. 1 and 2), which demonstrated: edema of the head of the pancreas with massive retropneumoperitoneum that was predominantly right-sided from the anterior pararenal space to the abdominal subcutaneous tissue, towards the posterior pararenal space, surrounding the psoas muscle and downwards to the prevesical and presacral spaces, even extending along the inguinal duct and towards the right lower limb through the femoral and obturator canals.
Given the hemodynamic instability and peritonism upon examination, emergency laparotomy was indicated, which confirmed the CT findings and ruled out a visceral perforation. We performed debridement of the necrotic tissue and drainage of the retroperitoneum.
Due to the septic condition of the patient, and in spite of the surgical drainage, the patient died 24h after surgery.
Please cite this article as: Argüelles BG, Sala Hernández Á, Ballester Ibánez C, Frasson M. Retroneumoperitoneo masivo secundario a pancreatitis aguda necrotizante. Cir Esp. 2017;95:110.
