Vol. 7, Issue 2, Part B (2025)

Background: Acute necrotizing pancreatitis is a life-threatening condition that may rapidly progress to multi-organ dysfunction syndrome (MODS). Early recognition and intensive supportive care are crucial in reducing morbidity and mortality.

Case Presentation: We report a case of a 30-year-old male with severe acute necrotizing pancreatitis, complicated by acute respiratory distress syndrome (ARDS), pleural effusion, acute kidney injury (AKI), ventilator-associated pneumonia, and ultimately MODS.

Investigations: Laboratory investigations revealed anemia, leukocytosis, metabolic acidosis, deranged renal and liver function tests, and positive cultures for multiple pathogens. Imaging confirmed necrotizing pancreatitis with fluid collections, ascites, pleural effusion, and omental thickening.

Treatment: The patient was managed with broad-spectrum antibiotics, organ support (mechanical ventilation, tracheostomy, SLED dialysis), nutritional support, and interventional procedures including intercostal drainage, percutaneous endoscopic drainage, and pigtail catheter insertion.

Outcome: Despite aggressive multidisciplinary care, the patient’s condition deteriorated and he succumbed to the illness.