Authors :
Bensal Abdelhak; Belhamidi Said; Moutaoukil Mohamed; Bouchentouf Sidi Mohamed; Moujahid Mountacer; Bounaim Ahmed
Volume/Issue :
Volume 5 - 2020, Issue 8 - August
Google Scholar :
http://bitly.ws/9nMw
Scribd :
https://bit.ly/3bwPnix
DOI :
10.38124/IJISRT20AUG536
Abstract :
Acute pancreatitis is a rare condition during
pregnancy. Gallstones are the most common etiology.Its
diagnosis should not suffer from delay because its
evolution can jeopardize the vital maternal and fetal
prognosis.We report the observation of woman, 27
years old, pregnant at 27 weeks of amenorrhea. She was
admitted for epigastric pain evolving for four days, her
lipasemia was at 360 IU / L. Abdominopelvic
ultrasound showed a thin-walled lithiasic gallbladder,
the non-dilated intra and extra hepatic bile ducts and an
enlarged pancreas; Active pregnancy with presence of
fetal heart activity. MRI performed immediately
objectified a multilithiasic gallbladder with moderate
dilation of the common bile duct, which is the site of 3
non-obstructive microlithiasis, the pancreas is enlarged.
The patient was put on rest with a diet low in lipids,
good rehydration (basic ration with electrolyte
supplementation, symptomatic treatment. satisfactory
check-up and she left after five days of hospitalization
with a check-up and possible cholecystectomy after
childbirth.
Acute pancreatitis rarely occurs during pregnancy;
the reported frequency ranges from 1 in 1000 to 3 in
10000 births. The most common etiology is cholelithiasis
in 70% of cases. According to Pitchumoni, more than
50% of acute pancreatitis occurs, as in our patient, in
the 3rd trimester. The clinical symptomatology and a
high lipasemia allow us to make the diagnosis of acute
pancreatitis. The abdominal ultrasound confirms the
biliary etiology, however she does not appreciate the
pancreas. The abdominal scanner cannot be performed
due to the risk of irradiation, we performed a biliMRI
whose sensitivity is 90% without risk either for the
mother or for the fetus. The management of acute
benign pancreatitis is done in collaboration with
gynecologists and is based on the diet to put to rest the
endocrine function of the pancreas and symptomatic
treatment with a good prognosis. In severe forms or
associated with cholangitis management is
multidisciplinary with a prognosis reserved for the
mother. A delay in diagnosis and treatment worsens the
prognosis. The medical treatment is identical to acute
pancreatitis outside of pregnancy, however there
remains the specific treatment of acute pancreatitis
secondary to cholelithiasis, because on the one hand we
must consider the high rate of recurrences during
pregnancy estimated at 70 %, and on the other hand
consider both the maternal risk which depends on the
anatomical type of acute pancreatitis and the gestational
age of onset, and the fetal risk which depends on the
severity of the clinical form.
Keywords :
Acute Pancreatitis, Pregnancy and abdominal pain.
Acute pancreatitis is a rare condition during
pregnancy. Gallstones are the most common etiology.Its
diagnosis should not suffer from delay because its
evolution can jeopardize the vital maternal and fetal
prognosis.We report the observation of woman, 27
years old, pregnant at 27 weeks of amenorrhea. She was
admitted for epigastric pain evolving for four days, her
lipasemia was at 360 IU / L. Abdominopelvic
ultrasound showed a thin-walled lithiasic gallbladder,
the non-dilated intra and extra hepatic bile ducts and an
enlarged pancreas; Active pregnancy with presence of
fetal heart activity. MRI performed immediately
objectified a multilithiasic gallbladder with moderate
dilation of the common bile duct, which is the site of 3
non-obstructive microlithiasis, the pancreas is enlarged.
The patient was put on rest with a diet low in lipids,
good rehydration (basic ration with electrolyte
supplementation, symptomatic treatment. satisfactory
check-up and she left after five days of hospitalization
with a check-up and possible cholecystectomy after
childbirth.
Acute pancreatitis rarely occurs during pregnancy;
the reported frequency ranges from 1 in 1000 to 3 in
10000 births. The most common etiology is cholelithiasis
in 70% of cases. According to Pitchumoni, more than
50% of acute pancreatitis occurs, as in our patient, in
the 3rd trimester. The clinical symptomatology and a
high lipasemia allow us to make the diagnosis of acute
pancreatitis. The abdominal ultrasound confirms the
biliary etiology, however she does not appreciate the
pancreas. The abdominal scanner cannot be performed
due to the risk of irradiation, we performed a biliMRI
whose sensitivity is 90% without risk either for the
mother or for the fetus. The management of acute
benign pancreatitis is done in collaboration with
gynecologists and is based on the diet to put to rest the
endocrine function of the pancreas and symptomatic
treatment with a good prognosis. In severe forms or
associated with cholangitis management is
multidisciplinary with a prognosis reserved for the
mother. A delay in diagnosis and treatment worsens the
prognosis. The medical treatment is identical to acute
pancreatitis outside of pregnancy, however there
remains the specific treatment of acute pancreatitis
secondary to cholelithiasis, because on the one hand we
must consider the high rate of recurrences during
pregnancy estimated at 70 %, and on the other hand
consider both the maternal risk which depends on the
anatomical type of acute pancreatitis and the gestational
age of onset, and the fetal risk which depends on the
severity of the clinical form.
Keywords :
Acute Pancreatitis, Pregnancy and abdominal pain.
