PMC2266717_01
CT scan on admission. Computed tomography on admission shows peripancreatic oedema, thickening of the Gerota's fascia on the left side and at least two poorly defined fluid collections (in other cuts) corresponding to severe acute pancreatitis with Balthazar grade E [21].
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F1
The diagnosis and severity of acute pancreatitis were verified with a CT scan (Fig. 1).
Transverse laparotomy incision. Seen from the patient's right side, a bilateral subcostal incision is being performed with posterior fascia still intact.
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F2
ACS was made and a decompressive laparostomy was performed 38 hours post-admission. A bilateral, wide subcostal incision about 5 cm below the costal margins was made and the fascial and muscle layers extending to about 5-8 cm lateral to the rectus sheats were divided on both sides (Fig. 2).
Completed laparostomy. Patches of liponecrosis seen on the surface of the greater omentum.
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F3
The abdomen or peripancreatic area were not explored further (Fig. 3) and the viscera were covered with a negative pressure dressing.