A 60-year-old male patient with a history of several episodes of acute pancreatitis of enolic origin. He presented with fever, general malaise, abdominal pain, nausea and vomiting of food. He was admitted to the Emergency Department where haemodynamic instability was observed with sinus tachycardia at 130x' and arterial hypotension (BP: 80/50 mmHg), for which reason he was transferred to the Intensive Care Unit (ICU).
Physical examination on arrival at the ICU revealed a large abdominal distension, with a diffuse painful abdomen and palpation of a mass at the epigastric level extending towards the left hypochondrium. Blood tests showed leukocytosis with significant left shift, hyperglycaemia, and a discrete elevation of both bilirubin and liver enzymes. After stabilisation, an abdominal CT scan showed a pancreatic pseudocyst measuring 17 x 8 centimetres in diameter that displaced the intestinal loops and compressed the stomach.

Transgastric drainage was attempted by means of endoscopic ultrasound but was not possible as the compression exerted by the mass made it impossible for the endoscope to progress. Several percutaneous drainage attempts were also made, all of which were unsuccessful. For this reason, it was decided to perform a surgical evacuation by marsupialisation of the pseudocyst by means of cystogastrostomy, obtaining a total of 4 litres of purulent material. Subsequent evolution was satisfactory and he was discharged from the ICU 6 days after admission.