ABSTRACT
Severe acute pancreatitis [SAP] is a serious frequent pathology in the Intensive Care Unit. The authors report a case of SAP complicated by extended digestive perforations with hepatic necrosis in a 24 year-old patient. The clinic and paraclinic data concluded to a baltazar stage E severe acute pancreatitis. A first intervention was decided on the 14th day of admittance to hospital due to the absence of clinic improvement despite the ressucitation. On the fifth day after surgery, the clinic condition is made serious on the infections level with hemodynamic instability. The surgical reintervention showed a brownish liquid with extended necrosis to all over the abdomen and mainly the sus mesocolic level. The surgery team opted for a therapeutic withrawal. Through this observation, the authors insist on the rarety of the mechanic complications of the severe acute pancreatitis whose diagnosis remains difficult and often late. When they exist, the evolution is often lethal