Fatal Abdominal Compartment Syndrome Due to Severe Triglyceride-Induced Pancreatitis in Early Pregnancy

Hypertriglyceridemia-induced pancreatitis after egg retrieval for in vitro fertilization and fenofibrate cessation

A 36-year-old woman with prior hypertriglyceridemia-induced pancreatitis presented with a recurrence of pancreatitis after beginning in vitro fertilization (IVF). Her primary care physician had discontinued fenofibrate due to concerns for teratogenicity. This case illustrates the importance of fibrate therapy for high-risk women undergoing IVF, despite limited evidence regarding its teratogenicity.

Hypertriglyceridemia induced pancreatitis complicated by compartment syndrome and managed by surgical decompression and plasmapheresis

Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis.

The patients with pancreatitis are at risk for both local and systemic complications.

Abdominal compartment syndrome is underdiagnosed and undertreated in this patient population. We report a case of 39-year-old male with medical history of diabetes mellitus who presented with abdominal pain and was diagnosed with HTG induced pancreatitis, complicated by abdominal compartment syndrome requiring surgical decompression and plasmapheresis.

Abruptio Placentae Caused by Hypertriglyceridemia-Induced Acute Pancreatitis during Pregnancy: Case Report and Literature Review

BACKGROUND

Hormonal effects during pregnancy can compromise otherwise controlled lipid levels in women with hypertriglyceridemia and predispose to pancreatitis leading to increased morbidity for mother and fetus. Elevation of triglyceride levels is a risk factor for development of pancreatitis if it exceeds 1000 mg/dL. Pancreatitis should be considered in emergency cases of abdominal pain and uterine contractions in Emergency Department at any stage of pregnancy. We report a case of abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Also, literature review of cases of acute pancreatitis induced by hypertriglycaemia in pregnancy has been made.

CASE

A 22-year-old woman presented to our Emergency Department, at 35 weeks of gestation, for acute onset of abdominal pain and uterine contractions. Blood tests showed a high rate of triglyceride. The patient was diagnosed with abruptio placentae caused by hypertriglyceridemia-induced acute pancreatitis. Immediate cesarean section was performed and it was observed that blood sample revealed a milky turbid serum. Insulin, heparin, and supportive treatment were started. She was discharged on the 10th day.

CONCLUSION

Consequently, patients with known hypertriglyceridemia or family history should be followed up more closely because any delay can cause disastrous conclusions for mother and fetus. Acute pancreatitis should be considered in pregnant women who have sudden onset, severe, persistent epigastric pain and who have a risk factor for acute pancreatitis.