scholarly journals Acute Pancreatitis in Pregnancy: Three Case Reports

2020 ◽  
pp. 1-3
Author(s):  
N Lemdaoui ◽  
N Lemdaoui ◽  
M Abdelmoumene ◽  
S Mammouche ◽  
A Bataiche ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Differential Diagnosis ◽  
Systemic Inflammatory Response Syndrome ◽  
Epigastric Pain ◽  
Case Reports ◽  
Rare Condition ◽  
Multiple Organ ◽  
The Third ◽  
Severe Pancreatitis ◽  
In Pregnancy

Acute pancreatitis is a rare condition during pregnancy, with peculiar specificities and particular findings. We report a series of 03 cases of pregnant women, treated for acute pancreatitis from 2016 to 2020. Their average age was 34.33 years and the diagnosis was based on clinical-biological clues: epigastric pain with strong elevation of lipasemia. Biliary etiology was confirmed in all patients initially by ultrasounds. Two patients had benign pancreatitis of favorable evolution. The third patient presented with a clinically severe pancreatitis and systemic inflammatory response syndrome, multiple organ failure syndrome with maternal and fetal deaths. Treatment was mainly symptomatic (medical), followed by cholecystectomy after delivery. Acute pancreatitis during pregnancy is a real threat for both the maternal and fetal prognosis and is a differential diagnosis that must be kept in mind for prompt management.

scholarly journals Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission

2019 ◽  
Vol 8 (2) ◽  
pp. 92-95
Author(s):  
Uttam Laudari ◽  
Abishek Thapa ◽  
Tanka Prasad Bohara ◽  
Shail Rupakheti ◽  
Mukund Raj Joshi
Keyword(s):  
Acute Pancreatitis ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Predictive Value ◽  
College Teaching ◽  
Systemic Inflammatory Response ◽  
P Value ◽  
Predictive Values ◽  
Acute Severe Pancreatitis ◽  
Severe Pancreatitis

Background: Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnea and change in blood leukocyte count. The relationship between SIRS symptoms at the time of presentation and severity of pancreatitis is yet to be determined though progression of SIRS in subsequent days has already been correlated.Objectives: To determine the severity of pancreatitis with SIRS score at the time of admission.Methodology: A retrospective cohort study of patients admitted to Department of Surgery, Kathmandu Medical College Teaching Hospital (KMCTH) with diagnosis of Acute Pancreatitis (AP) from December 2014 to January 2016 was conducted. Clinical, biochemical and imaging data were collected from the medical record section. Patients with diagnosis of acute pancreatitis as per Revised Atlanta Classification 2012 were included in the study. SIRS score at time of admission was correlated with Modified Marshall scoring system for organ dysfunction. Patients were grouped into severe and nonsevere group. Sensitivity, specificity and predictive values of SIRS score at admission for organ failure were calculated.Results: Among the 41 patients admitted with diagnosis of acute pancreatitis irrespective of cause, the sensitivity of SIRS score ≥2 at admission in predicting severe pancreatitis was 60 %, specificity was 20%, positive predictive value was 28% and negative predictive value was 20 %, with p-value of 0.52 and odds ratio of 1.6 (CI: 0.376-6.808).Conclusion: SIRS score at admission cannot be solely used in predicting acute severe pancreatitis. Patients can be stratified in resource deficit setting for timely referral to tertiary centre.

scholarly journals Protective Effect of Tetrandrine on Sodium Taurocholate-Induced Severe Acute Pancreatitis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xian-lin Wu ◽  
Jie-xing Li ◽  
Zhen-dong Li ◽  
Da-sheng Liu ◽  
Su-hong Lu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Free Radical ◽  
Bile Duct ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Protective Effect ◽  
Severe Acute Pancreatitis ◽  
Sodium Taurocholate ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction

Tet is a type of alkaloid extracted fromStephania tetrandra, and it has recently been demonstrated that Tet can protect against inflammation and free radical injury and inhibit the release of inflammatory mediators. The present study was designed to observe the protective effect of Tet on sodium taurocholate-induced severe acute pancreatitis (SAP). The rat model of SAP was induced by retrograde bile duct injection of sodium taurocholate and then treated with Verapamil and Tet. The results showed that Tet can reduce NF-κB activation in pancreas issue, inhibit the SAP cascade, and improve SAP through inducing pancreas acinar cell apoptosis and stabilizing intracellular calcium in the pancreas, thus mitigating the damage to the pancreas. Our study revealed that Tet may reduce systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndromes (MODS) to protect against damage, and these roles may be mediated through the NF-κB pathway to improve the proinflammatory/anti-inflammatory imbalance.

Acute Pancreatitis in Pregnancy: Maternal and Fetal Outcomes

2017 ◽  
Vol 9 (2) ◽  
pp. 106-109
Author(s):  
Asha Swarup ◽  
GS Jyothi ◽  
Shruti R Bhoosanoor
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Treatment Options ◽  
Abdominal Cavity ◽  
Age At Onset ◽  
Initial Assessment ◽  
Fetal Mortality ◽  
Fetal Outcomes ◽  
Mortality And Morbidity ◽  
In Pregnancy

ABSTRACT Aim and objective To evaluate the maternal and fetal outcomes in patients with acute pancreatitis. Materials and methods It is a retrospective observational study. A total of three patients were admitted with acute pancreatitis complicating pregnancy between January 2013 and June 2015 in the Department of Obstetrics and Gynaecology, M. S. Ramaiah Medical College and Hospital, Bengaluru, India, and were followed up until after delivery. Results Incidence of acute pancreatitis in our study was 1 in 1,620. Mean age was 24 years, and 33.3% were multiparous. Mean gestational age at onset was 33 weeks. One patient (33.3%) in our study had hypertriglyceridemia (870 mg/dL), and 66.7% of patients were idiopathic. The most common complaint was epigastric pain radiating to back. All patients showed leukocytosis and elevated amylase and lipase levels. Ultrasound showed [1] enlarged pancreas with decreased peripancreatic echogenicity and [2] pelvic and abdominal cavity effusions, in all the patients. All patients were managed conservatively in the intensive care unit. Mean duration of hospital stay was 7 days; 33.3% patients developed acute respiratory distress syndrome; 33.3% patients went into preterm spontaneous vaginal delivery. Cesarean section rate was 66.7%. Perinatal mortality was 33.3%. Conclusion Acute pancreatitis in pregnancy remains a challenging clinical problem to manage. The initial assessment, severity, and the initial management of the patient are of great importance in order to support the function and to prevent maternal and fetal mortality and morbidity. Clinical significance Acute pancreatitis either in its mild or its severe form causes maternal and fetal morbidity. However, these rates are declining due to early diagnosis and greater treatment options. Multidisciplinary approach leads to good maternal and fetal outcomes. How to cite this article Jyothi GS, Bhoosanoor SR, Swarup A. Acute Pancreatitis in Pregnancy: Maternal and Fetal Outcomes. J South Asian Feder Obst Gynae 2017;9(2):100-103.

Perinatal outcomes in pregnancies complicated by acute pancreatitis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emmy Cai ◽  
Nicholas Czuzoj-Shulman ◽  
Haim A. Abenhaim
Keyword(s):  
Acute Pancreatitis ◽  
Perinatal Outcomes ◽  
Rare Condition ◽  
The United States ◽  
Maternal Characteristics ◽  
International Classification Of Disease ◽  
Newborn Outcomes ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Abstract Objectives Acute pancreatitis is a rare condition that can be associated with significant complications. The objective of this study is to evaluate the maternal and newborn outcomes associated with acute pancreatitis in pregnancy. Methods A retrospective cohort study using the Healthcare Cost and Utilization Project – National Inpatient Sample from the United States was performed. All pregnant patients with acute pancreatitis were identified using International Classification of Disease-9 coding from 1999 to 2015. The effect of acute pancreatitis on maternal and neonatal outcomes in pregnancy was evaluated using multivariate logistic regression, while adjusting for baseline maternal characteristics. Results From 1999 to 2015, there were a total of 13,815,919 women who gave birth. There were a total of 14,258 admissions of women diagnosed with acute pancreatitis, including 1,756 who delivered during their admission and 12,502 women who were admitted in the antepartum period and did not deliver during the same admission. Acute pancreatitis was associated with increased risk of prematurity, OR 3.78 (95% CI 3.38–4.22), preeclampsia, 3.81(3.33–4.36), postpartum hemorrhage, 1.90(1.55–2.33), maternal death, 9.15(6.05–13.85), and fetal demise, 2.60(1.86–3.62) among women diagnosed with acute pancreatitis. Among women with acute pancreatitis, delivery was associated with increased risk of requiring transfusions, 6.06(4.87–7.54), developing venous thromboembolisms, 2.77(1.83–4.18), acute respiratory failure, 3.66(2.73–4.91), and disseminated intravascular coagulation, 8.12(4.12–16.03). Conclusions Acute pancreatitis in pregnancy is associated with severe complications, such as maternal and fetal death. Understanding the risk factors that may lead to these complications can help prevent or minimize them through close fetal and maternal monitoring.

scholarly journals Intraluminal duodenal (“windsock”) diverticulum: a rare cause of biliary obstruction and acute pancreatitis in the adult

2019 ◽  
Vol 07 (01) ◽  
pp. E87-E89 ◽  
Author(s):  
Petko Karagyozov ◽  
Ivan Tishkov ◽  
Zhenya Georgieva ◽  
Irina Boeva ◽  
Dimitar Tzankov
Keyword(s):  
Acute Pancreatitis ◽  
Biliary Obstruction ◽  
Epigastric Pain ◽  
Duodenal Diverticulum ◽  
Endoscopic Retrograde ◽  
Acute Calculous Cholecystitis ◽  
The Third ◽  
Intraluminal Duodenal Diverticulum ◽  
Calculous Cholecystitis ◽  
First Time

AbstractAn intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly, which is a result of incomplete recanalization of the foregut lumen during embryonic development. Most patients are asymptomatic. Symptoms usually occur after the third decade of life and mainly include epigastric pain, nausea, vomiting, or bloating. Less commonly, IDD may complicate with bleeding, duodenal obstruction, or acute pancreatitis. We present a case of IDD, manifested for a first time in adult with acute biliary obstruction and mild pancreatitis after laparoscopic cholecystectomy for acute calculous cholecystitis, successfully managed with endoscopic retrograde cholangiopancreatography (ERCP).

scholarly journals ACUTE PANCREATITIS IN PREGNANCY

2012 ◽  
Vol 19 (05) ◽  
pp. 747-750
Author(s):  
SHAMA CHAUDHRY ◽  
RUBINA HUSSAIN
Keyword(s):  
Acute Pancreatitis ◽  
Caesarean Section ◽  
Maternal Mortality ◽  
Dermoid Cyst ◽  
Conservative Management ◽  
Epigastric Pain ◽  
Fetal Loss ◽  
Pedal Edema ◽  
Severe Epigastric Pain ◽  
In Pregnancy

Acute pancreatitis during pregnancy is rarely encountered and can have a high maternal mortality and fetal loss. We report herea case of a 35-year-old woman para 1+0 previous 1LSCS at 32 weeks of gestation. She had laparotomy at 29 weeks of gestation due to torsionof dermoid cyst in this pregnancy. Now she was presented with, severe epigastric pain, vomiting and pedal edema. Investigation revealedhyperamylasemia and leukocytosis, hypokalemia, hypocalcaemia. The patient was kept on conservative management, antibiotics, analgesics& intravenous fluids.Pancreatitis resolved & she delivered at 38 weeks by caesarean section.

scholarly journals A rare case of primary gastric tuberculosis presenting as gastric outlet obstruction mimicking malignancy

2018 ◽  
Vol 4 (10) ◽  
pp. 263
Author(s):  
Kanika Singh ◽  
Sujata Raychaudhuri ◽  
Sheetal Gole ◽  
Anu Aggarwal
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Rare Condition ◽  
Surgical Excision ◽  
Giant Cells ◽  
Endoscopic Biopsy ◽  
Gastric Tuberculosis

<p>Gastric tuberculosis (TB), both primary and secondary is a rare condition. It is less common in immunocompetent individuals and in those without any antecedent pulmonary infection. The nonspecific complaints like epigastric pain, vomiting and weight loss may be confounding and lead to difficulty in diagnosis and differential diagnosis may include adenocarcinoma. We present a case of an immunocompetent male who presented with the above mentioned symptoms and on endoscopy showed an ulcerated region in the pyloric antrum with gastric outlet obstruction. A differential diagnosis of adenocarcinoma was suggested by the clinician. The endoscopic biopsy revealed granulomas and giant cells with no evidence of dysplasia. However, Ziehl-Neelson stain for acid fast bacilli was negative. The diagnosis of gastric tuberculosis was confirmed on Polymerase chain reaction (PCR) test for TB. A possibility of gastric tuberculosis should always be kept in mind in an endemic country like India with nonspecific abdominal complaints like epigastric pain, weight loss, vomiting etc. along with other differential diagnosis. A correct clinicopathological diagnosis would help in the appropriate treatment of the patient and would prevent unnecessary surgical excision.</p>

Congenital Segmental Intestinal Dilatation: A Clinical Dilemma

2021 ◽  
pp. 097321792110406
Author(s):  
Bhavya Kukreja ◽  
Ajay Prakash Mehta ◽  
Harsh Wardhan ◽  
Bhawna Sachdeva Narula ◽  
Poonam Sidana
Keyword(s):  
Differential Diagnosis ◽  
Neonatal Period ◽  
Case Reports ◽  
Rare Condition ◽  
Rare Clinical Entity ◽  
Preterm Baby ◽  
Neonatal Intestinal Obstruction ◽  
Segmental Dilatation ◽  
Clinical Dilemma ◽  
Segmental Dilatation Of Intestine

Congenital segmental dilatation of intestine is a rare clinical entity encountered in neonates with very few case reports from world over. It usually presents with symptoms of partial or total obstruction in neonatal period or infancy. We report a case of a preterm baby with segmental dilatation of intestine which was managed surgically. Diagnosis was confirmed intraoperatively as well as histologically. Consideration of this entity in differential diagnosis of neonatal intestinal obstruction may enable for better understanding and more reporting of this rare condition.

A Case Report of Familial Chylomicronemia Syndrome

2021 ◽  
Author(s):  
Mahtab Ordooei ◽  
Fariba Binesh ◽  
Azam Ashrafi ◽  
Farzad Ferdosian ◽  
Maryam Saeida-Ardekani
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Case Reports ◽  
Laboratory Data ◽  
Bone Marrow Aspiration ◽  
Rare Condition ◽  
Case Presentation ◽  
Blood Indices ◽  
High Triglyceride ◽  
High Uric Acid

Background: Diagnosis of neonatal chylomicronemia, as a very rare condition, is very difficult and usually is diagnosed when acute pancreatitis sets in. Early diagnosis can prevent the complications such as acute pancreatitis and pancreatic necrosis which are associated with the condition. Case Presentation: A 5.5 month- old female breastfed baby presented to us suffering from splenomegaly because of respiratory infection. Anemia and leukocytosis were seen in laboratory data. The result of bone marrow aspiration (BMA) performed to diagnosis was normal. Following the study, the patient had a high triglyceride, which improved with the treatment of symptoms and blood indices. Conclusion: Our case reports a rare disorder that was initially admitted with suspicion of malignancy, organomegaly, anemia and leukocytosis. In the course of hospitalization, the diagnosis of malignancy was rejected after BMA, and chylomicronemia was diagnosed and the patient's leukocytosis and high uric acid were eliminated by treatment of the disease and the patient's symptoms were improved.

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