Journal of the Formosan Medical Association
Volume 105, Issue 7 , Pages 583-587, 2006

Hypertriglyceridemia-associated Acute Pancreatitis with Chylous Ascites in Pregnancy

  • King-Teh Lee

      Affiliations

    • Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr King-Teh Lee, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, 100, Tzyou 1st Road, Kaohsiung 807, Taiwan
    • ,
  • Shen-Nien Wang

      Affiliations

    • Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Kung-Kai Kuo

      Affiliations

    • Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Jong-Shyong Chen

      Affiliations

    • Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan

Received 22 June 2005; received in revised form 28 July 2005; accepted 13 September 2005.

Article Outline

Both cholesterol and triglyceride levels in serum increase progressively during pregnancy. Hypertrigly-ceridemia is a well-recognized cause of acute pancreatitis, while pancreatitis-associated chylous ascites has rarely been reported. We report a 28-year-old female with coexistence of hypertriglyceridemia, acute pancreatitis, and chylous ascites during pregnancy. After emergency cesarean section, she was treated with nil per os, intravenous hydration, antibiotics, and analgesics as required. Due to the development of positive peritonitis 5 days later, an exploratory laparotomy was performed. Surgical interventions included pancreatic necrosec-tomy, right hemicolectomy and ileostomy, cholecystostomy, gastrostomy, and feeding jejunostomy. Postoperative treatment included antibiotics, total parenteral nutrition, and then low-fat diet with medium-chain triglyceride supplementation. She was discharged on the 43rd day after surgery and was free of symptoms during 6 months of follow-up. Ileocolostomy was performed 6 months after discharge. Fasting lipid profile should be regularly monitored during pregnancy due to the association of hypertriglyceridemia with development of acute pancreatitis in the mother.

Key Words:  acute pancreatitis , chylous ascites , hypertriglyceridemia , pregnancy

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PII: S0929-6646(09)60154-6

doi:10.1016/S0929-6646(09)60154-6

Journal of the Formosan Medical Association
Volume 105, Issue 7 , Pages 583-587, 2006

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