2022 Volume 37 Issue 2 Pages 67-73
A 27-year-old woman presented at 20 weeks gestation with upper abdominal pain. Laboratory tests revealed elevated pancreatic enzymes with prominent hypertriglyceridemia. Severe acute pancreatitis was diagnosed, and she was treated with aggressive fluid administration. Although respiratory deterioration and disseminated intravascular coagulation developed, she recovered successfully with strict lipid restriction and adequate fluid management. She was discharged on day 18. Walled-off necrosis was detected by MRI, but there was no sign of bacterial infection. She safely delivered twins by cesarean section at 36 weeks gestation. Serum triglyceride levels remarkably improved after delivery, but abnormalities in lipoprotein levels persisted. Thus, her marked hyperlipidemia was likely caused by a genetic predisposition in addition to pregnancy. Pregnancy affects lipid metabolism and can be a cause of acute pancreatitis. In this patient, collaboration with gastroenterologists and obstetricians helped to achieve successful outcomes for both mother and babies.
