LAUSR

Patients with acute pancreatitis can benefit more from step-up management. The minimally invasive approaches (MIA) could reduce complications, mortality, days, and expenses in hospitals. Even in these cases, they would still suffer fatal complications during the treatment. We present here a case of infected pancreatic necrosis (IPN) in a 51-year-old Chinese woman who developed a fatal cerebral embolism and died after a beneficial step-up procedure. The minimally invasive approach included surgical dual-scope necrosectomy and sequential non-narcotic nephroscopic pancreatic necrosectomy; a great improvement was made both in clinical condition and images after the advanced technique. Our case attempts to show that a dual-scope necrosectomy is a superior approach for patients with IPN. Cerebral embolism is a rare but life-threatening complication of severe acute pancreatitis (SAP). Patients with SAP may be at risk of cerebral embolism. If clinically suspected, necessary investigations should be arranged to look for causes. Once diagnosed, early treatment should be considered on a case-by-case basis.