scholarly journals The elevation of Creatine kinase in acute pancreatitis: a case report

2021 ◽  
Author(s):  
Mehdi Sheibani ◽  
Bahareh Hajibaratali ◽  
Houra Yeganegi
Keyword(s):  
Acute Pancreatitis ◽  
Creatine Kinase ◽  
Case Report ◽  
Chest Pain ◽  
False Positive ◽  
Epigastric Pain ◽  
Myocardial Involvement ◽  
Lab Test

Creatine Kinase (CK/CK-MB) testing is an essential lab test approaching patients with chest or epigastric pain. we report a 38-year-old man with acute pancreatitis and elevated CK/CK-MB level without myocardial involvement. Acute pancreatitis may be considered as a false positive cause of CK/CK-MB test in patients presenting with chest pain.

scholarly journals Skin signs in acute pancreatitis: a case report

2013 ◽  
pp. 265-268
Author(s):  
Marco Bassi ◽  
Gelorma Belmonte ◽  
Paola Billi ◽  
Angelo Pasquale ◽  
Massimo Reta ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Clinical Laboratory ◽  
Epigastric Pain ◽  
Multiorgan Failure ◽  
Fluid Collection ◽  
Clinical Signs ◽  
Pancreatic Fluid Collection ◽  
Retroperitoneal Hemorrhage ◽  
Skin Signs

Introduction: Subcutaneous manifestations of severe acute pancreatitis (Cullen’s sign, Gray- Turner’s sign, Fox’s sign, and Bryant’s sign) are often discussed in journals and textbooks, but seldom observed. Although historically associated with acute pancreatitis, these clinical signs have been described in various other conditions associated with retroperitoneal hemorrhage. Case report: We describe the case of a 61-year-old male with no history of alcohol intake, who was admitted for epigastric pain, vomiting, and increasing serum amylase and lipase levels. Five days after admission, ecchymotic skin discoloration was noted over both flanks (Gray-Turner’s sign) and the upper third of the thighs (Fox’s sign). Ten days later, he developed multiorgan failure and was transferred to the ICU for 5 days. Computed tomography revealed a large pancreatic fluid collection, which was subjected to EUS-guided drainage. Cholecystectomy was later performed for persistent obstructive jaundice. After more than 4 months of hospitalization, he died as a result of severe gastrointestinal bleeding. Discussion and conclusions: Skin manifestations of retroperitoneal hemorrhage in a patient with acute pancreatitis indicate a stormy disease course and poor prognosis. The severity of acute pancreatitis is currently estimated with validated scoring systems based on clinical, laboratory, and imaging findings. However, skin signs like the ones discussed above can represent a simple and inexpensive parameter for evaluating the severity and prognosis of this disease.

Recurrent Acute Pancreatitis in Pregnancy Caused by Parathyroid Hyperplasia: A Case Report and Literature Review

2020 ◽  
Vol 103 (9) ◽  
pp. 952-959
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Epigastric Pain ◽  
Present Report ◽  
Parathyroid Hyperplasia ◽  
Pathological Examination ◽  
Recurrent Acute Pancreatitis ◽  
First Case

Background: Hypercalcemia during pregnancy leads to multiple maternal and fetal complications. To date, fewer than 30 cases of primary hyperparathyroidism (PHPT)-induced pancreatitis have been diagnosed during pregnancy. Most cases have been caused by a parathyroid adenoma. In the present report, the author described the first case of PHPT due to parathyroid hyperplasia presented with recurrent, acute pancreatitis during pregnancy. Case Report: A 38-year-old female, with a history of acute pancreatitis during her first pregnancy, presented with severe epigastric pain, nausea, and vomiting for three days at 24 weeks of gestation. Parathyroid-dependent, hypercalcemia-induced recurrence of pancreatitis was diagnosed based on the clinical presentation and laboratory investigations. An ultrasound on her neck revealed a possible parathyroid adenoma located on the inferior pole of the left thyroid gland. She underwent an uneventful left-lower parathyroidectomy. The pathological examination revealed parathyroid hyperplasia. Her serum calcium and parathyroid hormone levels returned to normal after surgery. She delivered a healthy male newborn at gestational age 38 weeks without any complications. Conclusion: PHPT-induced acute pancreatitis during pregnancy is rare. Hypercalcemia, involving both total and ionized calcium, should be investigated in pregnant women who present with acute pancreatitis. Early diagnosis and appropriate management can significantly improve the maternal, fetal, and pregnancy outcomes. Keywords: Hypercalcemia, Recurrent pancreatitis, Pregnancy, Primary hyperparathyroidism, Parathyroid hyperplasia

An increase in creatine kinase secondary to acute pancreatitis: a case report

2005 ◽  
Vol 59 ◽  
pp. 40-42 ◽  
Author(s):  
I. Karachaliou ◽  
K. Papadopoulou ◽  
G. Karachalios ◽  
A. Charalabopoulos ◽  
V. Papalimneou ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Creatine Kinase ◽  
Case Report

scholarly journals Acute pancreatitis in a COVID-19 patient in Brazil: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Caroline Petersen da Costa Ferreira ◽  
Kalynne Rodrigues Marques ◽  
Gustavo Henrique Ferreira de Mattos ◽  
Tércio de Campos
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Epigastric Pain ◽  
White Male ◽  
Empiric Antibiotic Therapy ◽  
Pancreatic Involvement ◽  
Number Of Patients ◽  
Empiric Antibiotic

Abstract Background The consequences of the coronavirus disease 2019 pandemic have already exceeded 10 million infected and more than 560,000 deaths worldwide since its inception. Currently, it is known that the disease affects mainly the respiratory system; however, recent studies have shown an increase in the number of patients with manifestations in other systems, including gastrointestinal manifestations. There is a lack of literature regarding the development of acute pancreatitis as a complication of coronavirus disease 2019. Case report We report a case of acute pancreatitis in a white male patient with coronavirus disease 2019. A 35-year-old man (body mass index 31.5) had acute epigastric pain radiating to his back, dyspnea, nausea, and vomiting for 2 days. The patient was diagnosed with severe acute pancreatitis (AP)-APACHE II: 5, SOFA: 3, Marshall: 0; then he was transferred from ED to the semi-intensive care unit. He tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription-polymerase chain reaction, and his chest computed tomography findings were compatible with coronavirus disease 2019. Treatment was based on bowel rest, fluid resuscitation, analgesia, and empiric antibiotic therapy. At day 12, with resolution of abdominal pain and improvement of the respiratory condition, the patient was discharged. Conclusion Since there is still limited evidence of pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection, no definite conclusion can be made. Given the lack of other etiology, we consider the possibility that the patient’s acute pancreatitis could be secondary to coronavirus disease 2019 infection, and we suggest investigation of pancreas-specific plasma amylase in patients with coronavirus disease 2019 and abdominal pain.

scholarly journals LINAGLIPTIN-INDUCED PANCREATITIS

2020 ◽  
Vol 6 (1) ◽  
pp. e37-e39 ◽  
Author(s):  
Jorge Esteban Mosquera ◽  
Nancy Torres ◽  
Jorge Restrepo ◽  
Carlos Ruz-Pau ◽  
Sowmya Suryanarayanan
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Case Report ◽  
Epigastric Pain ◽  
The United States ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
First Case ◽  
Dipeptidyl Peptidase 4 Inhibitors

Objective: To report a case of linagliptin-induced acute pancreatitis and remind clinicians about risks with incretin-based drugs. Patients at risk for pancreatitis should be switched to another type of hypoglycemic treatment. Methods: We present the case of a 74-year-old Latina who presented to the emergency department with sudden onset of epigastric pain radiating to her back. Medical history, physical exam, laboratory tests, and medical images were compatible with acute pancreatitis. Upon further investigation, common causes for her pathology were excluded. Ten weeks prior to presentation she had changed her medications for diabetes mellitus type 2 to linagliptin. Results: Using the Naranjo algorithm of adverse drug reactions, we concluded that linagliptin was the most likely culprit. Conclusion: Incretin-based drugs, including dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists, have been shown to be relatively safe for the management of type 2 diabetes mellitus. Since their introduction to the market, conflicting data regarding pancreatic side effects have been published, including a small risk of developing acute pancreatitis with dipeptidyl peptidase-4 inhibitors like sitagliptin and saxagliptin. To date there has been only 1 case report associating linagliptin with acute pancreatitis in the English medical literature. Ours is the first case report in the United States associating linagliptin with acute pancreatitis. It is worth warning both patients and prescribers about this serious adverse effect, as it might affect the choice of antiglycemic agent.

Ep.Fri.329 Severe Acute Pancreatitis in Pregnancy Secondary to Hypertriglyceridemia – A Case Report and Literature Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Toks Fadipe ◽  
Sangara Narayanan Narayanasamy ◽  
Pradeep Thomas
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Epigastric Pain ◽  
Post Partum ◽  
Rare Complication ◽  
Medical Treatments ◽  
Targeted Screening ◽  
Rising Incidence ◽  
Pseudocyst Formation ◽  
In Pregnancy

Abstract Background Hypertriglyceridemia is a common and well characterized physiological phenomenon in pregnancy. Rarely does it complicate the pregnancy causing acute pancreatitis (APIP).  The majority of APIP cases arise secondary to gallstones. Hyperlipidaemia induced pancreatitis is a rarer cause with relatively worse outcomes with increased incidences of preterm delivery and pseudocyst formation. Case Report A 38-years-old woman at 29 weeks gestation presented with epigastric pain. The initial investigations revealed raised inflammatory markers, elevated amylase and hypertriglyceridemia. A diagnosis of APIP was made, prompting transfer to ITU. Foetal compromise necessitated an emergency Caesarean delivery. Post-partum, her clinical condition improved with NG feeding, bezafibrates and IV antibiotics. Her baby was transferred to a nearby tertiary neonatal unit with no immediate complications. Discussion Hyperlipidemia induced APIP requires intensive treatment. Various medical treatments for hypertriglyceridemia, such as fibrates and insulin infusions, have been described. Plasmapheresis in severe cases may benefit reducing the triglycerides level. Considering maternal and foetal morbidity and mortality, early diagnosis and multidisciplinary input is required to treat and reduce complications. Conclusion APIP is a serious and rare complication of pregnancy. The current lack of consensus on treatment of APIP warrants further inquiry, to minimise poor neonatal outcomes.  The merits of routine screening for gestational hypertriglyceridemia are yet to be elucidated; the morbidity associated with APIP, coupled with its rising incidence justify a targeted screening programme. Keywords Pancreatitis, Pregnancy, Hypertriglyceridemia.

scholarly journals Pseudo-Wellens syndrome, acute pancreatitis, and an anomalous coronary artery: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
V. S. Effoe ◽  
W. O’Neal ◽  
R. Santos ◽  
L. Rubinsztain ◽  
A. M. Zafari
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Chest Pain ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Cardiac Catheterization ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Epigastric Pain ◽  
The Right

Abstract Background Chest pain associated with transient electrocardiogram changes mimicking an acute myocardial infarction have been described in acute pancreatitis. These ischemic electrocardiogram changes can present a diagnostic dilemma, especially when patients present with concurrent angina pectoris and epigastric pain warranting noninvasive or invasive imaging studies. Case presentation A 45-year-old African-American man with a history of alcohol use disorder presented to the emergency department of our institution with 36 hours of concurrent epigastric pain and left-sided chest pain radiating to his left arm and associated with nausea and dyspnea. On physical examination, he was afebrile; his blood pressure was elevated; and he had epigastric tenderness. His laboratory test results were significant for hypokalemia, normal troponin, and elevated serum lipase and amylase levels. Serial electrocardiograms for persistent chest pain showed ST-segment elevations with dynamic T-wave changes in the right precordial electrocardiogram leads, consistent with Wellens syndrome. He was immediately taken to the cardiac catheterization laboratory, where selective coronary angiography showed normal coronary arteries with an anomalous origin of the right coronary artery from the opposite sinus. Given his elevated lipase and amylase levels, the patient was treated for acute alcohol-induced pancreatitis with intravenous fluids and pain control. His chest pain and ischemic electrocardiogram changes resolved within 24 hours of admission, and coronary computed tomography angiography showed an interarterial course of the right coronary artery without high-risk features. Conclusions Clinicians may consider deferring immediate cardiac catheterization and attribute electrocardiogram changes to acute pancreatitis in patients presenting with angina pectoris and acute pancreatitis if confirmed by normal cardiac enzymes and elevated levels of lipase and amylase. However, when clinical signs and electrocardiogram findings are highly suggestive of myocardial ischemia/injury, immediate noninvasive coronary computed tomography angiography may be the best approach to make an early diagnosis.

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Epigastric Pain ◽  
Umbilical Vein ◽  
History Of ◽  
Clinically Significant ◽  
Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

Posterior wall myocardial infarction: A case report

2017 ◽  
Vol 70 (1-2) ◽  
pp. 44-47
Author(s):  
Milenko Cankovic ◽  
Snezana Bjelic ◽  
Vladimir Ivanovic ◽  
Anastazija Stojsic-Milosavljevic ◽  
Dalibor Somer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Myocardial Revascularization ◽  
Posterior Wall ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Therapeutic Benefits ◽  
St Segment ◽  
Therapeutic Algorithms

Introduction. Acute myocardial infarction is a clinical manifestation of coronary disease which occurs when a blood vessel is narrowed or occluded in such a way that it leads to irreversible myocardial ischemia. ST segment depression in leads V1?V3 on the electrocardiogram points to the anterior wall ischemia, although it is actually ST elevation with posterior wall myocardial infarction. In the absence of clear ST segment elevation, it may be overlooked, leading to different therapeutic algorithms which could significantly affect the outcome. Case report. A 77 year-old female patient was admitted to the Coronary Care Unit due to prolonged chest pain followed by nausea and horizontal ST segment depression on the electrocardiogram in V1?V3 up to 3 mm. ST segment elevation myocardial infarction of the posterior wall was diagnosed, associated with the development of initial cardiogenic shock and ischemic mitral regurgitation. An emergency coronarography was performed as well as primary percutaneous coronary intervention with stent placement in the circumflex artery, the infarct-related artery. Due to a multi-vessel disease, surgical myocardial revascularization was indicated. Conclusion. Posterior wall transmural myocardial infarction is the most common misdiagnosis in the 12 lead electrocardiogram reading. Routine use of additional posterior (lateral) leads in all patients with chest pain has no diagnostic or therapeutic benefits, but it is indicated when posterior or lateral wall infarction is suspected. The use of posterior leads increases the number of diagnosed ST segment elevation myocardial infarctions contributing to better risk assessment, prognosis and survival due to reperfusion therapy.

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