PMC8549386_01
Forty-eight hour CT scan showing acute pancreatitis and peripancreatic fluid with no hypodense areas of pancreatic necrosis (yellow arrow).
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F1
Ca2+ level was 7.1 mg dl-1, base deficit 7.6 mmol l-1, blood urea nitrogen was 38.6 mg dl-1 and fluid requirements were >6000 ml (Table 1). Computerized tomography (CT) was then performed, which found acute pancreatitis without necrosis, but accompanied with peripancreatic fluid collection (Fig. 1).
CT scan revealing hypodense areas corresponding to pancreatic necrosis (green arrow).
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F2
CT scan was performed, which revealed necrotizing pancreatitis affecting up to the 40 % of the gland and there was also an increase of the peripancreatic fluid volume in relation to the previous CT scan (Fig. 2). Conservative treatments based on fluid, analgesic and oxygen requirements were intensified and 10 days later the patient was discharged to a conventional hospital ward.
CT scan showing gas collection (blue arrow) and a thrombus inside the portal vein (red arrow). These findings characterize emphysematous pancreatitis and phylephlebitis.
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F3
A CT scan was then performed, which found emphysematous pancreatitis with gas and fluid collection and filling defect in the spleno-portal vein system and portal gas (Fig. 3).