Suchin Dhamnaskar, Prashant Sawarkar, Varsha Kulkarni, Janesh M, Richard Menenzes
Context This is very rare and unreported complication of necrotising pancreatitis. Case report We report an unusual case of patient who developed pancreatic necrosis as a sequele of severe acute pancreatitis extending in retroperitoneum up to pre and para-vesical space resulting in enzymatic auto-digestion of urinary bladder wall leading to pancreatico-vesical fistula. Patient excreted significant amount of infected pancreatic necrosis through urine. Conclusion Patient was treated successfully with pigtail catheter drainage of infected necrosis initially, followed later by endoscope assisted minimally invasive pancreatic necrosectomy along pigtail catheter tract via retroperitoneal approach along with prolonged bladder decompression.