Severe acute necrotising pancreatitis caused by sodium valproate: a case report

Drug induced acute pancreatitis is an uncommon cause for acute pancreatitis. To make this diagnosis confidently, certain criteria should be fulfilled. The patient should be receiving the drug when acute pancreatitis develops and the pancreatitis should resolve with cessation of the drug. Also, other causes need to be excluded, and while the patient should ideally have recurrence of the pancreatitis if the drug is recommenced, as a confirmatory test this is not usually performed. A case is reported of severe acute necrotising pancreatitis associated with the use of sodium valproate. Sixteen years previously a similar but milder episode of possible acute pancreatitis occurred in this patient, resulting in cessation of sodium valproate. On the present occasion the patient required aggressive resuscitation, inotropic and ventilatory support, antibiotics and enteral feeding for a prolonged period before making a complete recovery.