Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis

Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis. We report a radioclinical observation of a 61-year-old female patient who consulted for epigastric pain radiating to the back, associated with vomiting and elevated lipasaemia more than 3 times the normal value. The abdominal computerized tomography (CT) scan carried out on the fourth day of hospitalization, based on worsening of the clinical condition, showed pancreatic necrosis associated with the presence of air bubbles. Percutaneous puncture of a peripancreatic collection was positive for Escherichia coli. A diagnosis of emphysematous pancreatitis was established. The clinical and biological evolution of our patient was favourable with antibiotic treatment. LEARNING POINTS: Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis. Abdominal CT allows for suspicion of this pathology based on the intra- and/or peripancreatic presence of air. The diagnosis is confirmed by the isolation of the bacterial agent in peripancreatic needle aspiration fluid.