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The abdominal vacuum-assisted closure (VAC) system has been introduced, providing a new possibility to treat an open abdomen. Abdominal compartment syndrome has a great relevance in surgical practice and patient care in critical condition, due to the effects of increased pressure in the enclosed space of the abdomen, possibly leading to multiple organ failure. We present a case of a 53 year-old woman with acute severe pancreatitis, admitted to intensive care unit with increasing abdominal pressure and rapid development of the compartment syndrome which overcame non-surgical manoeuvres, so that emergency surgery was imposed. The surgical procedure implied a laparostoma managed through negative pressure therapy. Severe cases of acute pancreatitis are associated with high mortality rate, secondary to early and late complications that develop as a consensus of the progression of the inflammatory and necrotic process. [ABSTRACT FROM AUTHOR]