Infected Walled-Off Necrosis Following COVID-19-Associated Acute Pancreatitis

Shota Yagi; Hideki Miwa; Yosuke Kobayashi; Kenta Mitsusada

doi:10.7759/cureus.51889

Infected Walled-Off Necrosis Following COVID-19-Associated Acute Pancreatitis

Cureus. 2024 Jan 8;16(1):e51889. doi: 10.7759/cureus.51889. eCollection 2024 Jan.

Authors

Shota Yagi^{1

2}, Hideki Miwa¹, Yosuke Kobayashi³, Kenta Mitsusada⁴

Affiliations

¹ Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
² Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, JPN.
³ Department of Gastroenterology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
⁴ Department of Emergency Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.

Abstract

A 54-year-old man was admitted for fever and dyspnea. He presented with severe COVID-19 pneumonia and elevated amylase and lipase levels. He received treatment for COVID-19 and possible acute pancreatitis (AP). Although pneumonia and amylase levels improved, a high-grade fever persisted. On day 39, abdominal CT revealed heterogenous liquid and non-liquid components with a well-defined wall around the pancreas, and he was diagnosed with infected walled-off necrosis (WON) after AP. It was concluded to be associated with COVID-19 because there were no identifiable causes, such as alcohol consumption, gallstones, or other viral infections. The necrotic collection and fever improved after endoscopic transgastric drainage and necrosectomy. SARS-CoV-2 is becoming recognized as a new etiological infectious factor for AP, and COVID-19-associated AP shows higher severity and mortality. Clinicians should evaluate COVID-19 patients for concomitant AP, and if it is present, they should carefully monitor the development of local complications, including WON.

Keywords: acute pancreatitis; covid-19; idiopathic pancreatitis; sars-cov-2; walled-off necrosis.

Publication types

Case Reports