2015 Volume 64 Issue 2 Pages 109-114
A 64-year-old female visited her local hospital in July 2013 with the chief complaint of epigastralgia. She was diagnosed with acute pancreatitis and treatments were started. The next day, worsening of the disease was determined and she was transferred to our hospital. Then intensive treatment was started with continuous regional arterial infusion of protease inhibitors, antibiotics, and continuous hemodiafiltration（CHDF）．Although inflammation improved gradually, on day 34, the patient developed fever. CT scan revealed walled-off necrosis（WON）near the superior mesenteric artery. Conservative treatment with antibiotics administration led to no improvement and therefore, transduodenal drainage and percutaneous transhepatic abscess drainage were performed. On day 84, the pseudo-aneurysm in the WON ruptured, and gastrointestinal bleeding occurred. Hemostasis was achieved by transarterial embolization. The patient made steady progress. Then she was discharged from the hospital on day 192. Here we experienced a case of severe acute pancreatitis that developed various complications and was successfully treated using multimodal therapy. We report our case with a brief review of the literature.
