# Huge, Infected Pancreatic Necrosis After Total Arch Replacement in a Patient With Immunoglobulin G4-Related Syndrome

## TL;DR

A patient with IgG4-related syndrome developed severe pancreatic necrosis after aortic arch replacement surgery.

## Contribution

This case highlights a rare complication of aortic surgery in patients with IgG4-related disease.

## Key findings

- Aortic arch replacement was performed in a patient with IgG4-related syndrome and aortic aneurysm.
- Post-surgery, the patient developed acute pancreatitis and later encapsulated necrosis.
- Debridement surgery led to clinical improvement.

## Abstract

A 77-year-old male patient with immunoglobulin (Ig)G4-related disease was diagnosed with a 60-mm aortic arch aneurysm and atherosclerosis of the aorta advanced throughout the body. Aortic arch replacement surgery was performed with circulatory arrest at 28°C. One week later, the patient developed acute pancreatitis, followed by encapsulated necrosis in the chronic phase. After debridement surgery, the patient’s condition improved.