Clinical Complexity of Acute Pancreatitis in a Patient With Jaundice Associated With Acute Hepatitis A, Cholelithiasis, and Recent Endoscopic Retrograde Cholangiopancreatography: A Case Report

The coexistence of gallstone disease, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, and acute hepatitis A is uncommon and presents significant diagnostic and therapeutic challenges. We reported a 26-year-old man who initially presented with a three-week history of jaundice and pruritus. He was diagnosed with acute pancreatitis associated with acute hepatitis A, ERCP, and gallstones. Following initial clinical improvement, the patient’s condition deteriorated, and contrast-enhanced CT demonstrated complications in the form of infected walled-off necrosis in the lesser sac and extensive infected acute necrotic collections, without vascular complications. He underwent laparotomy with cholecystectomy, necrosectomy, and drainage. Culture-directed intravenous antibiotics were administered for 14 days alongside supportive therapy, resulting in full clinical recovery.