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[Acute pancreatitis associated with hypercalcaemia].

Mauro Enrique Tun-Abraham1, Gabriela Obregón-Guerrero1, Larry Romero-Espinoza1

  • 1Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.

Cirugia Y Cirujanos
|July 1, 2015
PubMed
Summary

Primary hyperparathyroidism causing hypercalcemia is a rare but serious cause of acute pancreatitis. Surgical removal of parathyroid adenomas effectively treats this condition, preventing recurrence.

Keywords:
Acute pancreatitisHipercalcemiaHiperparatiroidismo primarioHypercalcaemiaPancreatitis agudaPrimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Primary hyperparathyroidism infrequently causes acute pancreatitis, affecting 1.5-8% of patients.
  • Pathophysiology may involve elevated parathyroid hormone and calcium levels leading to pancreatic duct calcification and enzyme activation.
  • This report details four cases of severe pancreatitis linked to primary hyperparathyroidism.

Observation:

  • Three patients experienced severe pancreatitis complications, including pseudocysts and pancreatic necrosis.
  • Diagnostic imaging, including cervical ultrasound, CT, and 99mTc-Sestamibi scintigraphy, identified parathyroid adenomas.
  • All four patients underwent successful surgical resection of the parathyroid adenoma.

Findings:

  • Acute pancreatitis associated with hypercalcemia from primary hyperparathyroidism is rare but typically severe.
  • Elevated serum calcium and parathyroid hormone levels are key indicators.
  • Imaging modalities are crucial for confirming the diagnosis.

Implications:

  • Early suspicion and diagnosis of primary hyperparathyroidism are vital in patients presenting with hypercalcemia and pancreatitis.
  • Surgical resection of parathyroid adenomas offers a definitive and effective treatment.
  • Prompt surgical intervention leads to excellent outcomes and prevents recurrent pancreatitis.