Hypertriglyceridemia-induced acute pancreatitis

Case contributed by Dr Yair Glick

Presentation

Pricking upper abdominal pain, radiating to chest and back, worsening on movement/lying down.

Patient Data

Age: 35 years
Gender: Female

Edematous pancreas, especially uncinate process, head, and neck, with fluid tracking between lobules. Extensive peripancreatic fluid collection. Reactive wall edema in duodenum surrounding the pancreatic head. A small amount of free intraperitoneal fluid in the lower abdomen.

Case Discussion

Amylase 114 IU/L (normal 28-100 IU/L), lipase 224 U/L (normal 13-60 U/L), cholesterol 501 mg/dL (normal 120-200 mg/dL), triglycerides 5489 mg/dL (normal 50-150 mg/dL). 

Hypertriglyceridemia treated urgently with plasmapheresis.

Hypertriglyceridemia-induced pancreatitis comprises 7% of cases of pancreatitis and is considered the third most common cause of pancreatitis after gallstones and alcohol 1.

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