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
Published In/Presented At
Cain, M. A., Ellis, J., Vengrove, M. A., Wilcox, B., Yankowitz, J., Smulian, J. C. (2015, September). Gallstone and Severe Hypertriglyceride-Induced Pancreatitis in Pregnancy. Obstetrical & Gynecological Survey, 70(9), 577-583.
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