[Hyperlipoproteinemia, a factor of severity in acute pancreatitis]

The authors make a retrospective analysis of 95 cases of acute pancreatitis hospitalized between 1975 and 1979. In 3,8% of all the cases the acute pancreatitis was associated with hyperlipoproteinemia. The study of the 4 patients involved revealed the primary origin of hyperlipoproteinemia as a result of alimentary abuse in 3 of the cases. In a fourth case the increased serum lipoproteins were due to prolonged use of contraceptives. From the clinical viewpoint, pancreatitis associated with hyperlipoproteinemia was more severe, with signs of shock and collapse, respiratory failure, high serum nitrogen an hyperglycemia. The blood and the serum had a lactescent aspect, with a thick layer of chylomicrons. The serum and blood values for lipids were higher than 4000 mg%. The increase in the amount of lipids was especially due to high triglycerides values. From the anatomopathologic viewpoint the 4 patients presented as acute cases of cholecysto-pancreatitis with major and extensive haemorrhagic necrosis which involved almost the entire pancreas. The evolution of the four patients was difficult. Two of the patients recovered after a long hospitalization, and had definitive sequels - insulin-dependent diabetes. The other two patients died following septic complications (bronchopneumonia and visceral gangrene), and hypovolemia due to upper digestive haemorrhage.