Title

Gallstone and Severe Hypertriglyceride-Induced Pancreatitis in Pregnancy.

Publication/Presentation Date

9-25-2015

Abstract

IMPORTANCE: Patients with biliary disease or underlying dyslipidemias are at risk for pancreatitis in pregnancy. Appropriate treatment can decrease the risk of recurrence and perinatal complications. Prevention of severe lipid elevations can prevent the development of pancreatitis in pregnancy.

OBJECTIVE: To review the pathophysiology, diagnosis and treatment of gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy.

EVIDENCE ACQUISITION: We performed a literature search regarding pancreatitis, gallstones, hyperlipidemia, and the treatment of both severe hypertriglyceride-induced pancreatitis and gallstone pancreatitis in pregnancy.

RESULTS: In the setting of acute pancreatitis, removal of the offending agent, either gallstones or serum lipids, can lead to improved status and decrease recurrence risk.

CONCLUSIONS AND RELEVANCE: Patients with acute pancreatitis should be treated with analgesia and fluid resuscitation and maintain a nothing-per-os status. In cases of gallstone pancreatitis, removal of the offending stone through endoscopic retrograde cholangiopancreatography or cholecystectomy can decrease recurrence risk. Severe hypertriglyceride-induced pancreatitis includes similar management. Lipopheresis may be considered in refractory cases. Patients with severe hypercholesterolemia should maintain a low-fat diet and can continue lipid-lowering agents outside the statin class of medications. Preventing severe dyslipidemia in gestation can decrease the risk of pancreatitis and improve maternal and neonatal outcomes.

Volume

70

Issue

9

First Page

577

Last Page

583

ISSN

1533-9866

Disciplines

Endocrinology, Diabetes, and Metabolism | Medical Sciences | Medicine and Health Sciences | Obstetrics and Gynecology

PubMedID

26403561

Department(s)

Department of Medicine, Department of Medicine Faculty, Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology Faculty

Document Type

Article