Title: Acute Pancreatitis in Third Trimester of Pregnancy: A Case Report

Authors: Dr Suganya Devi. A , Dr Bhuvana.S.

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.132

Abstract

  

Acute pancreatitis is a rare and serious complication during pregnancy, which can have a high maternal mortality and perinatal mortality. Acute pancreatitis in pregnancy poses diagnostic and therapeutic challenges. The most common cause of acute pancreatitis in pregnancy is gallstones and hypertriglyceridemia. We report a case of acute pancreatitis in a pregnant woman in her third trimester and discuss the analytical and restorative challenges of acute pancreatitis in pregnancy. Even though it is a rare, acute pancreatitis should be suspected in all pregnant patients admitted for non-obstetric abdominal pain. Early diagnosis and good supportive care by a multidisciplinary team are essential to ensure good maternal and fetal outcome.

Keywords: Acute pancreatitis, pregnancy, hypertriglyceridemia, prognosis, treatment.

References

  1. Vege SS, Yadav D, Chari ST. Pancreatitis. In: GI Epidemiology, 1st ed, Talley NJ, Locke GR, Saito YA (Eds), Blackwell Publishing, Malden, MA 2007.
  2. Ducarme, F. maire, P. Chatel, D. Luton, P. hammel. “Acute pancreatitis during pregnancy: a review”. Journal of Perinatology 2014; 34:87-94.
  3. Efstathios P. Papadakis, Maria Sarigianni, Dimitri P. Mikhailidis, Apostolos Mamopoulos, Vasilios Karagiannis. “Acute pancreatitis in pregnancy: an overview. European Journal of obstetrics and Gynecology and Reproductive Biology” 2011; 159:261-266.
  4. Bahiya Abdullah, Thanikasalam Kathiresan Pillai, Lim HuayCheen, and Ray Joshua Ryan. “Severe acute pancreatitis in pregnancy. Case Reports in Obstetrics and Gynecology” 2015;
  5. Sarles H. Pancreatitis symposium. Basel SK, Marseille 1963.
  6. Sarles H. Revised classification of pancreatitis--Marseille 1984.  Dig Dis Sci 1985; 30:573.
  1. Pitchumoni C. S., Yegneswaran B. “Acute pancreatitis in pregnancy”. World Journal of Gastroenterology. 2009; 15(45):5641–5646. doi: 10.3748/wjg.15.5641.
  2. Ko C. W., Beresford S. A. A., Schulte S. J., Matsumoto A. M., Lee S. P. “Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy”.  Hepatology. 2005; 41(2):359–365. doi: 10.1002/hep.20534.
  3. Eddy J. J., Gideonsen M. D., Song J. Y., Grobman W. A., O’Halloran P. “Pancreatitis in pregnancy”. Obstetrics and Gynecology.  2008; 112(5): 1075–1081. doi: 10.1097/AOG.0b013e318185a032.
  1. Mindaugas Serpytis, Vytautas Karosas, Rokas Tamosauskas, et al. “Hypertriglyceridemia – induced acute pancreatitis in pregnancy”. JOP J Pancreas (Online) 2012 Nov; 13(6):677-680.
  2. Thulasidass K., Chowdhury T. A. “Hypertriglyceridemic pancreatitis in pregnancy: case reports and review of the literature”. JRSM Short Reports. 2013; 4(8):1–3. doi: 10.1177/2042533313481211.
  3. Noel R. A., Braun D. K., Patterson R. E., Bloomgren G. L. “Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study”. Diabetes Care. 2009; 32(5):834–838. doi: 10.2337/dc08-1755. 
  4. Sahu S, Raghuvanshi S, Bahl DV, Sachan P. “Acute Pancreatitis In Pregnancy”. Int J Surg. 2006; 11: Number 2.
  5. Papadakis E. P., Sarigianni M., Mikhailidis D. P., Mamopoulos A., Karagiannis V. “Acute pancreatitis in pregnancy: an overview”. European Journal of Obstetrics Gynecology and Reproductive Biology.  2011; 159(2):261–266. doi: 10.1016/j.ejogrb.2011.07.037. 
  6. Pandey R., Jacob A., Brooks H. “Acute pancreatitis in pregnancy: review of three cases and anaesthetic management”. International Journal of Obstetric Anesthesia. 2012; 21(4):360–363.  doi: 10.1016/j.ijoa.2012.07.004.
  1. Banks P. A., Bollen T. L., Dervenis C., et al. “Classification of acute pancreatitis”—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62(1):102–111. 
  2. Tang S.-J., Rodriguez-Frias E., Singh S., et al. “Acute pancreatitis during pregnancy”. Clinical Gastroenterology and Hepatology. 2010; 8(1):85–90. doi: 10.1016/j.cgh.2009.08.035. 
  3. Štimac T., Štimac D.Acute Pancreatitis During Pregnancy”. 2012.
  4. Jafri N. S., Mahid S. S., Idstein S. R., Hornung C. A., Galandiuk S. “Antibiotic prophylaxis is not protective in severe acute pancreatitis: a systematic review and meta-analysis”. The American Journal of Surgery. 2009; 197(6):806–813. doi: 10.1016/j.amjsurg.2008.08.016.
  1. Wilkinson E. J. “Acute pancreatitis in pregnancy: a review of 98 cases and a report of 8 new cases”. Obstetrical and Gynecological Survey. 1973; 28(5):281–303. doi: 10.1097/00006254-197305000-00001.
  2. Zhang D.-L., Huang Y., Yan L., Phu A., Ran X., Li S.-S. “Thirty-eight cases of acute pancreatitis in pregnancy: a 6-year single center retrospective analysis”. Journal of Huazhong University of Science and Technology [Medical Sciences]2013; 33(3):361–367. doi: 10.1007/s11596-013-1125-8. 
  1. Sun Y., Fan C., Wang S. “Clinical analysis of 16 patients with acute pancreatitis in the third trimester of pregnancy”. International Journal of Clinical and Experimental Pathology. 2013; 6(8):1696–1701.
  2. Shoaib Gangat A. R., Muhammad A., Saher F., Ameer A., Iqbal Ahmed M. “Frequency of acute pancreatitis in pregnancy and it’s outcome”.  Pakistan Journal of Surgery. 2009; 25(2):69–71.

Corresponding Author

Dr Suganya Devi. A

Postal Address- Sri Devi Explosives, Opp. R.C.Plant, Raman Nagar (Post), Mettur Dam- 636 403,

Salem (District), India