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Avneet Kaur and T. Lirangla Sangtam
Acute pancreatitis is characterised by inflammation of pancreas which can be of
varying severity depending on the local and systemic complications [1]. Pancreatitis
can be interstitial which is comparatively mild or associated with necrosis. Necrotising
pancreatitis are characterised by non-viable pancreatic tissue associated with surrounding
fat necrosis. It can be associated with collections that in acute stage are called acute
necrotising collections and in chronic stages are called walled off necrosis (WON) [2].
Severe acute pancreatitis can involve the surrounding gastrointestinal tract leading to
formation of a fistula. The causes of it can be the direct erosion of the surrounding organs
by the inflammation of pancreas or due to vascular thrombosis causing necrosis of an
area of inflammation. It may present as haemorrhage or sepsis [3]. An enterovesical fistula
(Figure 1) is an extremely rare complication of necrotising pancreatitis. Pseudoaneurysms
are another rare set of complications associated with pancreatitis that can occur due
to the pancreatic enzymes eroding the surrounding planes [4]. This case involves the
simultaneous presence of these uncommon scenarios in a single patient.