Severe acute pancreatitis of gallblader origin with sequels: pancreatic necrosis, pseudocyst and splenic vein thrombosis Mochón Benguigui, Sol Navarro Freire, Francisco Severe acute pancreatitis Chylous ascites Pancreatic pseudocyst Left portal hypertension Surgery Pancreatitis aguda grave Ascitis quilosa Pseudoquiste pancreático Hipertensión portal izquierda Cirugía 40 year old male with ulcerative gastritis, cholelithiasis and severe acute pancreatitis with long-term hospital stay, requiring tracheal intubation and tracheotomy. Chyloperitoneum, cholelithiasis and pancreatic pseudocyst with a 90% necrosis without active bleeding were found during surgery. Cholecistectomy, washing and intracavitary necrosectomy, stitching of the small vascular intracystic stump, Roux-en-Y cystojejunostomy, draining of the chyloperitoneum and of the cavity were performed. Chylous ascites persisted and was treated with octeotride, diuretics and fat-free diet supplemented with medium-chain trigliyerides, proteins and vitamins. However, sequels remained including: recurrent acute pancreatitis, splenic vein thrombosis and left portal hypertension. As the patient was not diabetic and the platelet count was 140000 cells/mm3 splenectomy or expectant monitoring were posed as possible choices. The interest of the case is rooted in the diagnosis, treatment and evolution of the chylous ascites, 90% pancreatic necrosis, pseudocyst and splenic vein thrombosis, as well as the repeated admissions. 2021-06-23T08:24:39Z 2021-06-23T08:24:39Z 2016 info:eu-repo/semantics/article Mochón Benguigui, Sol; Navarro Freire, Francisco. Severe acute pancreatitis of gallblader origin with sequels: pancreatic necrosis, pseudocyst and splenic vein thrombosis. AMU. 2016; 4: 37-41 2341-0361 http://hdl.handle.net/10481/69347 eng http://creativecommons.org/licenses/by-nc-nd/3.0/es/ info:eu-repo/semantics/openAccess Atribución-NoComercial-SinDerivadas 3.0 España Archivos de Medicina Universitaria