Hyperlipidemic pancreatitis during pregnancy

A case of acute pancreatitis associated with type V hyperlipoproteinemia is reported. A 26-year-old-woman was referred to our department with nausea, vomiting, and severe abdominal pain at 24weeks gestation. Elevation of pancreatic enzymes with profound hypertriglyceridemia (60mmol/L) was noticed, and a diagnosis of hyperlipidemic pancreatitis was made on the day of admission. Because she had no history of non-gestational hyperlipidemia, the observed hyperlipidemia was thought to be gestational in origin. The treatment consisted of nasogastric decompression, intravenous hyperalimentation, insulin infusion, and plasma exchanges. Progressive abatement of the symptoms occured, and on the fifth day of admission, complete resolution was observed. On the seventh day of hospitalization, advancing preterm labor and associated fetal distress was diagnosed, which necessitated a cesarean delivery: The infant was lost due to severe immaturity. Pancreatic pseudocyst formation complicated the postpartum period, which was managed by percutaneous drainage. Early diagnosis, close monitoring, consistent supportive treatment and awareness of complications are the key points in the management of gestational pancreatitis.