# A Case of Life-Threatening Postpartum Necrotizing Pancreatitis Requiring Gastrocystostomy With Serial Pancreatic Necrosectomies

## TL;DR

A 37-year-old woman developed severe postpartum necrotizing pancreatitis requiring multiple surgeries and prolonged hospitalization.

## Contribution

This case report highlights the rare and severe presentation of postpartum necrotizing pancreatitis and its management challenges.

## Key findings

- The patient required endoscopic gastrocystostomy and four pancreatic necrosectomies for source control.
- Despite treatment, she experienced complications requiring readmission after discharge.
- The case underscores the life-threatening nature of postpartum necrotizing pancreatitis.

## Abstract

We present a life-threatening case of postpartum acute necrotizing pancreatitis. The patient is a 37-year-old female with no past medical history who delivered a healthy baby boy via cesarean section. Twenty days later, she presented to the emergency department with acute onset of nausea, non-bloody vomiting, abdominal bloating, and epigastric pain radiating to the back. Less than 24 hours later, she progressed into septic shock despite aggressive resuscitation, requiring vasopressor support in the ICU. Initial CT imaging showed multiple patchy hypodensities throughout the pancreas consistent with severe necrotizing pancreatitis. Her hospitalization was further complicated by difficulty obtaining source control of her infection, Clostridium difficile, and nutritional deficiencies that resulted in gross anasarca. She was discharged from the hospital on day 59 after undergoing multiple percutaneous drain placements, IV antibiotics, and endoscopic gastrocystostomy with four pancreatic necrosectomies. Since discharge, the patient has required readmission twice for complications from her pancreatitis.