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[A 25-year old woman with abdominal pain and respiratory failure].

BACKGROUND
About 25% of patients with acute pancreatitis progress into severe pancreatitis with local and systemic complications. Local complications include oedema, necrosis, haemorrhage, infections, abscesses and pseudocysts. Systemic complications frequently involve the lungs and the kidneys in addition to cardiovascular dysfunction with hypotension and shock. Multi-organ failure is caused by a systemic inflammatory response commonly seen in necrotising pancreatitis, a severe condition with high mortality (about 30%). Similar pathogenesis is seen in sepsis or severe burns.


METHODS
We report a young woman with acute pancreatitis and have used available literature to discuss the clinical picture and the pathogenesis, with an emphasis on the systemic complications.


RESULTS AND INTERPRETATION
Systemic complications like multi-organ failure are frequently reported in acute severe pancreatitis characterised by pancreatic oedema and necrosis. Our patient had abdominal pain and mild pancreatitis without radiological manifestations. She developed systemic complications with respiratory failure not previously reported in mild pancreatitis. Early identification of systemic complications in acute pancreatitis is important in order to start treatment and reduce the risk of a fatal outcome.