Postpartum pancreatitis: A case report

Abstract

The case is a 39-year-old parous female with a history of untreated hyperlipidemia. She presented at another hospital at 37 weeks gestation with the chief complaint of epigastralgia, and was diagnosed with acute pancreatitis due to elevated pancreatic enzymes. Complication with severe neonatal asphyxia led to her transferal to this hospital, where an emergency cesarean section was performed the same day. Severe acute pancreatitis was diagnosed based on three prognostic factors and CT Grade 3, and the patient was admitted to the ICU. Progress with conservative treatment was favorable, and she was discharged from hospital on the 20th day of admission after her symptoms receded. While acute pancreatitis in pregnancy is rare, there are reports of approximately 100 cases in Japan. The rate of gestational pancreatitis due to hyperlipidemia in Japan is high, and swift diagnosis and treatment is required as the prognosis is often poor. In this case, familial type IV hyperlipidemia was suspected due to the patient's history of hyperlipidemia and family history. Exacerbation of hyperlipidemia due to pregnancy is thought to have induced onset of pancreatitis.