Abstract
Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that can lead to severe systemic complications, including multi-organ failure and systemic inflammatory response syndrome (SIRS). While gastrointestinal and metabolic manifestations are well-documented, cardiovascular and neurological presentations are rare. This case describes an atypical presentation of AP in a young, otherwise healthy male, who initially experienced bilateral ascending lower limb pain and weakness. These symptoms progressed to lower abdominal pain, nausea, vomiting, and breathlessness. An electrocardiogram upon presentation revealed atrial fibrillation. This constellation of signs and symptoms presented a diagnostic challenge; however, subsequent blood tests and imaging confirmed the diagnosis of AP. Despite aggressive management in the intensive care unit, the condition rapidly progressed to multi-organ failure, resulting in death. This case underscores the importance of early recognition of atypical presentations of AP. Physicians, especially those in emergency departments, should maintain a high index of suspicion to enable early intervention and prevent fatal outcomes.