Amir Washma, Nawaz Marrium, Ahmed Zohaib
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2020 Mar 21;12(3):e7348. doi: 10.7759/cureus.7348.
Acute pancreatitis (AP) in pregnancy and post-partum period is a rare event and can have a lethal effect on the mother and the fetus. Gallstone disease is thought to be the most common causative factor of AP; however, in many cases the cause remains unclear. Here, we present a case of severe AP occurring in late pregnancy which aggravated in the early postpartum period. A 32-year-old multiparous woman, para 7, presented with severe abdominal pain, abdominal distension and multiple episodes of vomiting. The pain was localized to the upper abdomen and radiating to the back, aggravated by food and bending forward. She had neither a history of chronic alcoholism nor any evidence of viral infection was found. The patient was diagnosed with idiopathic severe AP on contrast-enhanced computed tomography, which was managed conservatively and recovered within several days. She did not have any recurrence thereafter and had a good clinical recovery. Therefore, it is important to consider AP when a woman presents with upper abdominal pain, nausea and vomiting in pregnancy and during the postpartum period to improve the maternal outcome for patients with AP.
妊娠及产后急性胰腺炎(AP)是一种罕见事件,可对母亲和胎儿产生致命影响。胆结石疾病被认为是AP最常见的致病因素;然而,在许多情况下病因仍不明确。在此,我们报告一例发生在妊娠晚期的重症AP病例,该病例在产后早期病情加重。一名32岁、孕7产的经产妇,出现严重腹痛、腹胀及多次呕吐。疼痛局限于上腹部并向背部放射,进食和向前弯腰时加重。她既无慢性酒精中毒史,也未发现任何病毒感染证据。经增强CT检查,该患者被诊断为特发性重症AP,经保守治疗数天内康复。此后未再复发,临床恢复良好。因此,当孕妇及产后妇女出现上腹部疼痛、恶心和呕吐时,考虑到AP对于改善AP患者的母婴结局很重要。