Severe acute pancreatitis following a prolonged spinal surgery in the prone position

Abstract

A 76-year-old woman underwent spinal surgery, for a compression fracture of thoracic vertebra #12, in the prone position. The surgery was prolonged for 6 hours 20 minutes with massive bleeding. After the spinal surgery, she developed abdominal pain due to acute pancreatitis. The next day, enhanced CT showed grade 2 pancreatitis. She was diagnosed as a severe acute pancreatitis and treatment for pancreatitis was started. However, on the 16^th day post-surgery, enhanced CT revealed infected pancreatic necrosis with duodenal necrosis and perforation. A pancreaticoduodenectomy (PD) was performed and reconstruction was carried out according to Child's method. The pancreas head and the duodenum were widely necrosed and the duodenum was perforated with a retroperitoneal abscess formation. After PD, she recovered without major complications.