Hypertriglyceridemic pancreatitis in pregnancy: case reports and review of the literature
A 24-year-old woman was admitted with acute abdominal pain. She had been diagnosed with hypertriglyceridemia during an admission with pancreatitis two years previously (), and treated with a statin and fibrate, achieving reasonable control of her hypertriglyceridemia. On examination, she had signs of peritonism, blood pressure 88/42 mmHg and pulse 130 regular. Serum amylase was 8962 (normal range <90 U/L). Pregnancy test was positive, and ultrasound confirmed a gravid uterus of approximately eight weeks’ gestation, and oedema of the pancreatic head. She was admitted to intensive care, treated with antibiotics, intravenous fluids and starvation. Her condition deteriorated, developing adult respiratory distress syndrome, requiring respiratory and inotropic support. She suffered foetal loss at day 4, but slowly recovered, without the need for laparotomy. Computerized tomography of the abdomen showed necrotizing pancreatitis, but no fluid collection or pseudocyst formation. She was discharged at day 17, back on her lipid lowering medication. She was given advice to avoid pregnancy in the near future.