A 43-year-old woman on the waiting list for cholecystectomy for symptomatic gallstones and resection of hepatic adenoma (6.7 cm x 5.3 cm x 6.8 cm, segment II-III).
She suffered acute epigastric abdominal pain radiating to both hypochondria, nausea and vomiting.
Blood tests showed an amylase of 3315 IU/L (normal range: 25-115 IU/L), with no other findings; the patient was admitted with a diagnosis of acute biliary pancreatitis, without Ranson criteria.
Abdominal ultrasound showed a gallbladder with multiple stones, dilatation of the intrahepatic and extrahepatic bile duct, with a diffusely enlarged pancreas.
She required admission to the Intensive Care Unit due to poor evolution with oligoanuria in the first days of admission. Abdominal computed tomography (CAT) showed Balthazar grade E pancreatitis.
During his prolonged stay in the plant he presented numerous complications: pulmonary condensation with associated pleural effusion (Klebsiella pneumoniae in sputum), infection of the urinary tract (Candida albicans), sepsis by catheter haemolyticus venous catheter and severe enterococcal
In a control abdominal CAT scan, severe stenosis was observed at the level of the hepatic angle of the colon with thickening of folds and various fistulous tracts, which were confirmed with opaque, opaque, multilayer
The lack of response to conservative treatment was programmed for surgical intervention performed ileocolic bypass, cholecystectomy and resection of the hepatic adenoma.
She is currently asymptomatic, with a normal abdominal CT scan.
