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Int J Clin Exp Pathol 2013;6(8):1696-1701

Case Report
Clinical analysis of 16 patients with acute pancreatitis in the third trimester of pregnancy

Yanmei Sun, Cuifang Fan, Suqing Wang

Renmin Hospital of Wuhan University, Wuhan University, Wuhan, 430060, China; School of Public Health, Wuhan University, Wuhan, 430071,
China

Received April 30, 2013; Accepted June 20, 2013; Epub July 15, 2013; Published August 1, 2013

Abstract: Aim: Acute pancreatitis (AP), in particular, severe acute pancreatitis (SAP), is a rare but challenging complication during pregnancy in
terms of diagnosis and management. The objective of this paper is to investigate the causes and therapeutic strategies of AP in patients
during the third trimester of pregnancy. Methods: We performed a retrospective analysis of the clinical features, laboratory data, and outcomes
in 16 patients with acute pancreatitis during the third trimester of pregnancy. Results: Information was collected on admission, management,
and outcome. A total 16 patients were diagnosed with acute pancreatitis during pregnancy. In 7 of 9 patients with mild AP, pregnancy was
terminated by cesarean section and all 9 cases were cured. In 4 out of 7 patients with SAP, pregnancy was terminated by cesarean section in
conjunction with peritoneal irrigation and drainage, and the mothers and infants survived. In the remaining 3 patients with SAP, there was one
case of intrauterine death in which Induced labor was performed and 2 patients died of multiple organ failure. Conclusion: A high-fat diet and
cholelithiasis are the triggers of AP in pregnancy. Conservative treatment is the preferred therapeutic method; in particular, for mild AP.
Endoscopic surgery and peritoneal drainage are effective for acute biliary pancreatitis. Patients with hyperlipidemic pancreatitis should undergo
lipid-lowering therapy, and hemofiltration should be done as soon as it becomes necessary. For patients with SAP, termination of pregnancy
should be carried out as early as possible. (IJCEP1304040).

Keywords: Acute pancreatitis, pregnancy, hyper triglyceride, treatment

Address correspondence to: Dr. Suqing Wang, Department of Nutrition and Food Hygiene, School of Public Health, Wuhan University, 115
Donghu Rd, Wuhan, Hubei, 430071, China. Phone: (86) 27-68759972; Fax: (86) 27-68758648; E-mail: swang2099@whu.edu.cn