Abstract
Diaphragmatic hernia (DH) is a condition characterized by the passage of abdominal content into the thorax. The acute symptoms associated with this entity are uncommon, pancreatic herniation being very rare. A 73-year-old patient with acute pain in the upper abdomen, distributive shock, with tomographic findings of the passage of abdominal contents into the thorax, including the pancreas, is described. The association between acute symptoms, pancreatic diaphragmatic herniation, and distributive shock is extremely rare. A case of a patient with severe acute pancreatitis secondary to DH requiring comprehensive management in the Intensive Care Unit is presented.