scholarly journals Nontraumatic Acute Elevation of Pancreatic Enzymes following Percutaneous Nephrolithotomy: A Rare Complication

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Nikolaos Ferakis ◽  
Antonios Katsimantas ◽  
Georgios Zervopoulos ◽  
Vasileios Klapsis ◽  
Spyridon Paparidis ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Systemic Inflammatory Response Syndrome ◽  
Percutaneous Nephrolithotomy ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Imaging Studies ◽  
Acute Elevation ◽  
Pathologic Findings

Herein, we report the case of a 48-year-old female who developed nontraumatic acute pancreatitis following left supracostal Percutaneous Nephrolithotomy. Three hours postoperatively, the patient developed fever with signs and symptoms consistent with hydrothorax, which was confirmed radiologically and was managed conservatively. The following days, the patient developed manifestations of Systemic Inflammatory Response Syndrome with epigastric pain, nausea, and vomiting. Blood, urine, and sputum cultures were negative. Serum amylase and lipase levels were elevated 3 and 13 times above the normal level, respectively. Imaging studies revealed no pathologic findings from pancreas. These findings were consistent with the diagnosis of acute pancreatitis.

scholarly journals Acute Pancreatitis Secondary to Hemobilia after Percutaneous Liver Biopsy: A Rare Complication of a Common Procedure, Presenting in an Atypical Fashion

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ramy Mansour ◽  
Justin Miller
Keyword(s):  
Acute Pancreatitis ◽  
Liver Biopsy ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Transcatheter Embolization ◽  
Percutaneous Liver Biopsy ◽  
Imaging Studies ◽  
Common Procedure ◽  
Elevated Alkaline Phosphatase ◽  
Negative Imaging

Percutaneous Liver Biopsy is an often-required procedure for the evaluation of multiple liver diseases. The complications are rare but well reported. Here we present a case of a 60-year-old overweight female who underwent liver biopsy for elevated alkaline phosphatase. She developed acute pancreatitis secondary to hemobilia, with atypical signs and symptoms, following the biopsy. She never had the classic triad of RUQ pain, jaundice, and upper GI hemorrhage. There were also multiple negative imaging studies, thus complicating the presentation. She was successfully treated with ERCP, sphincterotomy, balloon sweep, and stent placement. Angiography and transcatheter embolization were not required.

scholarly journals The Management of Multi-Site, Bleeding, Visceral Artery Pseudoaneurysms, Secondary to Necrotising Pancreatitis

2009 ◽  
Vol 91 (3) ◽  
pp. 255-258 ◽  
Author(s):  
J Skipworth ◽  
D Raptis ◽  
D Brennand ◽  
C Imber ◽  
A Shankar
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Fistula Formation ◽  
Visceral Artery ◽  
Haemodynamic Instability ◽  
Successful Recovery ◽  
Necrotising Pancreatitis ◽  
Tomographic Angiography

We present the case of a 45-year-old man, who presented to his local casualty department with severe epigastric pain following an alcohol binge, and was subsequently diagnosed with acute pancreatitis. Pancreatic necrosis with multiple collections ensued, necessitating transfer to an intensive care unit (ITU) in a tertiary hepatopancreaticobiliary centre. Initially, the patient appeared to slowly improve and was discharged to the ward, albeit following a prolonged ITU admission. However, during his subsequent recovery, he suffered multiple episodes of haematemesis and melaena associated with haemodynamic instability and requiring repeat admission to the ITU. Computerised tomographic angiography, followed by visceral angiography, was used to confirm the diagnosis of multisite visceral artery pseudoaneurysms, secondary to severe, necrotising pancreatitis. Pseudoaneurysms of the splenic, left colic and gastroduodenal arteries were sequentially, and successfully, radiologically embolised over a period of 9 days. Subsequent sequelae of radiological embolisation included a clinically insignificant splenic infarct, and a left colonic infarction associated with subsequent enterocutaneous fistula formation. The patient made a prolonged, but successful, recovery and was discharged from hospital after 260 days as an in-patient. This case illustrates the rare complication of three separate pseudoaneurysms, secondary to acute pancreatitis, successfully managed radiologically in the same patient. This case also highlights the necessity for multidisciplinary involvement in the management of pseudoaneurysms, an approach that is often most successfully achieved in a tertiary setting.

scholarly journals Rare complication of milk-alkali ingestion: severe pancreatitis and acute kidney injury in a chronic hypocalcaemic patient with DiGeorge’s syndrome

2019 ◽  
Vol 12 (3) ◽  
pp. e226761 ◽  
Author(s):  
Rajarshi Bhadra ◽  
Fareeha Ahmed Khan ◽  
Mona Soliman ◽  
Meyappan Somasundaram ◽  
Daniel V Iltchev ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Renal Dysfunction ◽  
Epigastric Pain ◽  
Calcium Supplementation ◽  
Rare Complication ◽  
Biliary Duct ◽  
Thiazide Diuretics ◽  
Prolonged Stay ◽  
Calcium Supplements ◽  
Severe Renal Dysfunction

Injudicious use of over-the-counter calcium supplements has resulted in increased incidences of hypercalcaemia and related complications. We present a case of acute pancreatitis in a chronic hypocalcaemic patient of DiGeorge’s syndrome. The patient came into the ED with sepsis syndrome, right upper quadrant and epigastric pain and no obvious source of infection. Lab results and imaging were indicative of acute pancreatitis. There was severe renal dysfunction. The patient needed haemodialysis and had a prolonged stay in intensive care. The medical history was negative for biliary duct pathology or alcohol use. The patient had vomiting and diarrhoea in the nursing home for about a week, but she continued to receive her regular medications that included the calcium supplements and thiazide diuretics. It is likely that a complex interplay between calcium supplementation, dehydration and thiazide diuretics resulted in the development of acute pancreatitis and severe renal dysfunction in a chronic hypocalcaemic patient.

scholarly journals Abdominal pain and a raised amylase? It’s not always pancreatitis…

2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
High Serum ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.

scholarly journals Paradoxical air embolism during percutaneous nephrolithotomy due to patent foramen ovale: Case report

2015 ◽  
Vol 9 (9-10) ◽  
pp. 658 ◽  
Author(s):  
Daljeet Chahal ◽  
Vladimir Ruzhynsky ◽  
Iain McAuley ◽  
Desmond Sweeney ◽  
Paul Sobkin ◽  
...  
Keyword(s):  
Case Report ◽  
Percutaneous Nephrolithotomy ◽  
Medical Management ◽  
Patent Foramen Ovale ◽  
Rare Complication ◽  
Air Embolism ◽  
Signs And Symptoms ◽  
Foramen Ovale ◽  
Fatal Complication ◽  
Intraoperative Echocardiography

Paradoxical air embolism is a very rare complication associated with percutaneous nephrolithotomy (PCNL). Incidence may be higher if patients also suffer from a septal heart defect. We report the case of a 76-year old male who presented for PCNL treatment of a right kidney lower calyceal calculus. During the procedure, the patient developed signs and symptoms consistent with that of air embolism. Intraoperative echocardiography confirmed the diagnosis. Subsequent intraoperative and postoperative medical management was carried out and the patient was discharged after recovery three days later. This case highlights the importance of a rare but potentially fatal complication of PCNL.

scholarly journals Patients with Non-diagnostic Hyperamylasaemia Must be Investigated and Managed as per Acute Pancreatitis

2012 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Huw G Jones ◽  
Nicky Jardine ◽  
Jeremy Williamson ◽  
Malcolm CA Puntis ◽  
Gareth J Morris-Stiff
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Biliary Tree ◽  
University Hospital ◽  
Amylase Level ◽  
Median Serum ◽  
Drug History ◽  
Clinical Dilemma ◽  
Upper Abdominal

Objectives The identification of hyperamylasaemia insufficient to confidently diagnose acute pancreatitis in patients with epigastric pain poses a clinical dilemma. The aim of this study was to identify a cohort of such patients and review their presentation, investigation and outcome. Design Patients admitted through the emergency surgical intake during a 12-month period with serum amylase levels of 100–400 IU/L were identified and case notes reviewed to confirm those presenting with upper abdominal pain. Subsequent radiological and biochemical investigations were recorded. Participants A total of 25 patients with non-diagnostic hyperamylasaemia. Setting Ward patients in a University Hospital. Main outcome measures Amylase level, eventual diagnosis, drug history. Results Twenty-five patients were identified with a mean age of 46.7 years. The median serum amylase level was 230 IU/L (range 102–358 IU/L). Twenty-two patients underwent transabdominal ultrasound at presentation, with gallstones identified in nine cases. The remaining three had documented gallstones and were awaiting elective cholecystectomy. Of the 13 patients with no evidence of cholelithiasis, six were taking medications known to cause pancreatitis, seven patients underwent computed tomography (CT) scans that identified chronic pancreatitis in three, and were non-diagnostic in four cases. These four patients underwent endoscopic ultrasound (EUS) evaluation of the biliary tree identifying microlithiasis in one but no pathology in the remaining three cases. Conclusions Patients with hyperamylasaemia not diagnostic of pancreatitis should be carefully investigated, as gallstones will be identified in at least 50%. An accurate drug history is also invaluable.

scholarly journals Coronavirus Disease-19-associated Acute Pancreatitis: Report of Three Cases and Review of Case Reports

2021 ◽  
Vol 9 (C) ◽  
pp. 63-69
Author(s):  
Fahmi Yousef Khan ◽  
Theeb Osama Sulaiman ◽  
Arun Prabhakaran Nair ◽  
Mohamed Elmudathir Osman
Keyword(s):  
Acute Pancreatitis ◽  
Normal Limit ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Case Reports ◽  
Good Condition ◽  
Elevated Serum ◽  
Nausea And Vomiting ◽  
Severe Epigastric Pain ◽  
Pcr Test

BACKGROUND: Reports on coronavirus disease 2019 (COVID-19) associated with acute pancreatitis continue to emerge. In this series, we present three cases of acute pancreatitis associated with COVID-19 with no obvious etiology. CASE REPORTS: The first case was a 47-year-old man who presented with severe abdominal periumbilical pain, preceded by fever and dry cough. Based on a positive COVID-19 polymerase chain reaction (PCR) test and elevated serum amylase and lipase >3 times the upper normal limit, the diagnosis of COVID-19 and acute pancreatitis were established. The next case was a 57-year-old man with confirmed COVID-19 who developed severe epigastric pain radiating to the back and was associated with nausea and vomiting. His serum amylase and lipase were elevated >3 times the upper normal limit confirming the diagnosis of acute pancreatitis. The third case was a 31-year-old man who presented to the emergency department with a few hours of severe epigastric pain radiating to the back associated with nausea and vomiting. Two days before his presentation, he had a runny nose and fever. A combination of serum amylase and lipase elevation, >3 times the upper normal limits, and a positive COVID-19 PCR test were obtained concurrently, confirming the diagnosis of COVID-19 associated acute pancreatitis. All patients were admitted to the Mesaieed Hospital COVID-19 facility and received treatment for COVID-19 according to our local guidelines, while acute pancreatitis was treated conservatively. All three patients were discharged in good condition. CONCLUSION: This case series suggests a possible correlation between COVID-19 and acute pancreatitis.

scholarly journals Comparison of ultrasound and serum amylase in the diagnosis of acute pancreatitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4030
Author(s):  
Manoharan G. V. ◽  
Maharaja P.
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Serum Amylase ◽  
Imaging Modality ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Amylase Level ◽  
Age Group ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: Acute pancreatitis is an inflammatory disease of the pancreas. Though, severe acute pancreatitis constitutes 15-20% of all cases of pancreatitis, in recent times, mortality rate of severe acute pancreatitis has reduced from 30-80% to 15-20%. Ultrasound is the first imaging modality in most centres for the preliminary screening of an acute abdomen.Methods: In this prospective study between October 2017 to March 2019, 113 patients with clinical signs and symptoms of acute pancreatitis were screened with an ultrasonogram of the abdomen and serum amylase in the emergency room. Patients also underwent a complete physical exam.Results: In our study 38.9% of patients were in the age group of 45-55 years, 25% in the 35-45 age group and 20.4% in the 55 to 70 age group. 92.9% of the patients were men. 89.4% of the participants had a history of alcoholism. Only 37.2% of the participants who were clinically positive for acute pancreatitis, also showed USG findings for acute pancreatitis while 69% of the clinically positive patients showed serum amylase level positive for acute pancreatitis.Conclusions: Ultrasonogram though cheap and easily available is not ideal for the diagnosis of acute pancreatitis. As shown in the study serum amylase is able to detect nearly twice as many cases of pancreatitis compared to ultrasonogram. The sensitivity and specificity of ultrasonography to detect acute pancreatitis is too low to use as a diagnostic test but it is a valuable tool in the evaluation of an acute abdomen.

Ep.Fri.329 Severe Acute Pancreatitis in Pregnancy Secondary to Hypertriglyceridemia – A Case Report and Literature Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Toks Fadipe ◽  
Sangara Narayanan Narayanasamy ◽  
Pradeep Thomas
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Epigastric Pain ◽  
Post Partum ◽  
Rare Complication ◽  
Medical Treatments ◽  
Targeted Screening ◽  
Rising Incidence ◽  
Pseudocyst Formation ◽  
In Pregnancy

Abstract Background Hypertriglyceridemia is a common and well characterized physiological phenomenon in pregnancy. Rarely does it complicate the pregnancy causing acute pancreatitis (APIP).  The majority of APIP cases arise secondary to gallstones. Hyperlipidaemia induced pancreatitis is a rarer cause with relatively worse outcomes with increased incidences of preterm delivery and pseudocyst formation. Case Report A 38-years-old woman at 29 weeks gestation presented with epigastric pain. The initial investigations revealed raised inflammatory markers, elevated amylase and hypertriglyceridemia. A diagnosis of APIP was made, prompting transfer to ITU. Foetal compromise necessitated an emergency Caesarean delivery. Post-partum, her clinical condition improved with NG feeding, bezafibrates and IV antibiotics. Her baby was transferred to a nearby tertiary neonatal unit with no immediate complications. Discussion Hyperlipidemia induced APIP requires intensive treatment. Various medical treatments for hypertriglyceridemia, such as fibrates and insulin infusions, have been described. Plasmapheresis in severe cases may benefit reducing the triglycerides level. Considering maternal and foetal morbidity and mortality, early diagnosis and multidisciplinary input is required to treat and reduce complications. Conclusion APIP is a serious and rare complication of pregnancy. The current lack of consensus on treatment of APIP warrants further inquiry, to minimise poor neonatal outcomes.  The merits of routine screening for gestational hypertriglyceridemia are yet to be elucidated; the morbidity associated with APIP, coupled with its rising incidence justify a targeted screening programme. Keywords Pancreatitis, Pregnancy, Hypertriglyceridemia.

scholarly journals Acute pancreatitis associated with severe acute respiratory syndrome coronavirus-2 infection: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abdullah S. Eldaly ◽  
Ayman R. Fath ◽  
Sarah M. Mashaly ◽  
Muhammed Elhadi
Keyword(s):  
Acute Pancreatitis ◽  
Risk Factor ◽  
Severe Acute Respiratory Syndrome ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
White Male ◽  
Nasopharyngeal Swab ◽  
Published Data ◽  
Serum Lipase ◽  
Pancreatic Involvement

Abstract Introduction We report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation. Case presentation An otherwise healthy 44-year-old white male from Egypt presented to the hospital with severe epigastric pain and over ten attacks of nonprojectile vomiting (first, gastric content, then bilious). Acute pancreatitis was suspected and confirmed by serum amylase, serum lipase, and computed tomography scan that showed mild diffuse enlargement of the pancreas. The patient did not have any risk factor for acute pancreatitis, and extensive investigations did not reveal a clear etiology. Given a potential occupational exposure, a nasopharyngeal swab for polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was done, which was positive despite the absence of the typical symptoms of severe acute respiratory syndrome coronavirus 2 such as fever and respiratory symptoms. The patient was managed conservatively. For pancreatitis, he was kept nil per os for 2 days and received intravenous lactated Ringer’s (10 ml per kg per hour), nalbuphine, alpha chymotrypsin, omeprazole, and cyclizine lactate. For severe acute respiratory syndrome coronavirus 2, he received a 5-day course of intravenous azithromycin (500 mg per day). He improved quickly and was discharged by the fifth day. We know that abdominal pain is not a rare symptom of severe acute respiratory syndrome coronavirus 2, and we also know that elevated levels of serum amylase and lipase were reported in severe acute respiratory syndrome coronavirus-2 patients, especially those with severe symptoms. However, the association between severe acute respiratory syndrome coronavirus-2 infection and idiopathic acute pancreatitis is rare and has been reported only a few times. Conclusion We believe further studies should be conducted to determine the extent of pancreatic involvement in severe acute respiratory syndrome coronavirus-2 patients and the possible causality between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis. We reviewed the literature regarding the association between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis patients. Published data suggest that severe acute respiratory syndrome coronavirus 2 possibly could be a risk factor for acute pancreatitis.

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