LAUSR

Acute pancreatitis is the most common indication for hospitalization in the USA among all digestive diseases [1]. Cases of acute pancreatitis may be complicated by various local as well as systemic sequelae. Fluid accumulation in and/or around the pancreas represents a common complication and can lead to pseudocyst or walled-off pancreatic necrosis (WOPN) formation, which, in some instances, may cause mass effect on surrounding structures. Here, we present the first reported case of acute portal hypertension with new onset ascites formation due to compression of the main portal vein by a large WOPN collection. In addition, we describe the multimodal approach to addressing the patient’s comorbidities, dual anti-platelet therapy need, and largevolume ascites (a relative contraindication to transluminal procedures) in the development of a comprehensive treatment plan for the WOPN and its associated complications.