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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Acute pancreatitis associated with primary hyperparathyroidism.

Alberto Biondi¹, Roberto Persiani, Michele Marchese

¹Emergency and General Surgery Unit, Fondazione IRCCS Ca' Granda Policlinico Maggiore, Via F. Sforza 35, 20122 Milan, Italy. biondi.alberto@tiscali.it

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Summary

This case report highlights a potential causal link between severe hypercalcemia from primary hyperparathyroidism and acute pancreatitis. Medical management of high calcium levels resolved pancreatitis symptoms, paving the way for successful surgery.

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Area of Science:

Endocrinology
Gastroenterology
Surgical Case Reports

Background:

Primary hyperparathyroidism and acute pancreatitis frequently coexist.
A definitive causal relationship between these conditions remains debated in medical literature.

Observation:

A patient presented with acute pancreatitis as the initial symptom of primary hyperparathyroidism.
Severe hypercalcemia was noted in the patient.

Findings:

Medical therapy successfully reduced serum calcium levels, resolving pancreatitis symptoms within 10 days.
A parathyroid adenoma was identified, and subsequent parathyroidectomy normalized hormone and calcium levels.
No pancreatitis recurrence or complications were observed at three-year follow-up.

Implications:

This case supports a causal link between acute pancreatitis and severe hypercalcemia.
Severe hypercalcemia should be considered in the differential diagnosis of non-biliary, non-alcoholic acute pancreatitis.
Medical reduction of hypercalcemia may facilitate surgical intervention for primary hyperparathyroidism.