Acute Fulminant Pancreatitis in a Patient with Excessive Erythrocytosis
Abstract:
Introduction: Severe acute pancreatitis is associated with a high morbidity and mortality due to the development of pancreatic and extrapancreatic necrosis, and subsequently necrotic tissue infection resulting in multisystem organ failure. Excessive erythrocytosis and hyperviscosis could promote hypoperfusion and ischemia of pancreatic tissue, favorecing the systemic inflamatory response (SIRS) and worsening the curse of the acute pancreatitis.
Case Presentation: We describe the case of a 71-year-old male patient from Arequipa, who worked in La Riconada, Puno, the place with the highest altitude above sea level (5300 msnm) in Peru. The patient presented to the emergency department with several abdominal pain and dyspnea, the physical examination revealed peritonial irritation and cyanosis in the extremities, and análisis revealed a posible coagulation disorder. The patient presented with severe acute pancreatitis along with acute respiratory failure requiring an intensive care unit for management. Extreme polycythemia and insufficient management quickly led to necrotizing pancreatitis that led to multisystem failure and death of the patient.
Conclusion: In conclusion, we report a case of severe acute pancreatitis in a patient with extreme polycythemia that rapidly led to necrotizing pancreatitis, multiorganic failure and patient death, which is not commonly reported in the literature in the management of patients diagnosed with severe pancreatitis.
