Lucknow, Aug 25: Regency Health Lucknow successfully managed a complex case involving Mr. Krishna Chandra, a 72–year–old man, who was admitted with severe upper abdominal pain and repeated episodes of vomiting and was diagnosed with acute severe pancreatitis, complicated by respiratory failure, acute kidney injury, pneumonia, urinary tract infection, encephalopathy and neurological weakness. The patient was treated under the care of Dr. Praveen Jha, DM – Gastroenterology, Dr. Sumit Verma – Neurology, and the critical care team.
The patient was admitted on 16 June 2026 with complaints of upper abdominal pain and vomiting that had started early that morning. His medical history included COPD for four years and a previous episode of acute pancreatitis approximately five years earlier. At admission, his blood sugar was elevated at 357 mg/dl.
Following evaluation, investigations including abdominal ultrasonography revealed acute edematous pancreatitis with peripancreatic inflammatory changes, along with other findings requiring close monitoring. The patient was initially managed with intravenous fluids, antibiotics, proton-pump inhibitors, antiemetics, insulin, nebulisation, human albumin and other supportive treatment.
As his condition progressed, the patient developed severe breathlessness and respiratory distress. He was initially placed on non-invasive ventilation; however, when he was unable to maintain adequate oxygen saturation, Patient while on ventilator developed weakness of both upper and lower limbs. Clinically, diagnosed to be LMN quadriparesis/GBS. At that point, patient had severe weakness and was not able to move his limbs. Further, investigations like nerve conduction velocity and CSF supported the diagnosis of GBS subsequently IVIG was administered and gradually patient started improving. He required elective intubation and mechanical ventilator support. He also developed hypotension requiring noradrenaline support. Further neurological evaluation revealed chronic left frontal lobe infarct with encephalopathy changes and diffuse cerebral atrophy.
The clinical course became further complicated on 25 June 2026, when the patient developed sudden bradycardia followed by cardiac arrest. The critical care team immediately initiated CPR according to ACLS AHA guidelines, administered emergency medications, successfully revived the patient and continued mechanical ventilator support. A lumbar puncture was subsequently performed for further neurological evaluation, while chest and limb physiotherapy were continued.
With intensive multidisciplinary management and continuous monitoring, the patient’s condition gradually improved. On 6 July 2026, he successfully underwent a T-piece trial and was extubated. Ventilator support was gradually weaned, followed by intermittent NIV support, and the patient was shifted to the HDU and subsequently to the ward after becoming hemodynamically stable.
The patient responded well to the treatment and supportive care provided by the multidisciplinary team. At the time of discharge on 18 July 2026, he was afebrile, had no fresh complaints and had stable vital signs. He was advised continued limb and chest physiotherapy, general supportive care and a low-fat diabetic diet, along with follow-up with Gastro-medicine and Neurology.
The successful management of this challenging case highlights the importance of timely diagnosis, intensive critical care and coordinated multidisciplinary treatment in patients with severe acute pancreatitis complicated by respiratory, renal, neurological and infectious complications. The case also demonstrates Regency Health Lucknow‘s capability in managing critically ill patients through coordinated care involving gastroenterology, neurology and critical care specialists.