[Acute pancreatitis and pregnancy]

Area of Science:

• Obstetrics and Gynecology
• Gastroenterology
• Surgical Case Reports

Background:

• Acute pancreatitis during pregnancy is uncommon and poses diagnostic challenges.
• Gallstones are a frequent cause of acute pancreatitis in pregnant individuals.
• Managing acute pancreatitis necessitates a focus on maternal and fetal well-being.

Observation:

• A 37-year-old woman at 32 weeks gestation presented with acute pancreatitis attributed to gallstones.
• Initial medical management was followed by a recurrent episode, necessitating intervention.
• Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy was performed, leading to symptom improvement.

Findings:

• The ERCP procedure successfully managed the acute episode, allowing for an uncomplicated delivery, puerperium, and breastfeeding.
• A subsequent acute episode 15 days postpartum prompted a cholecystectomy.
• The case underscores the importance of timely and appropriate interventions for acute pancreatitis in pregnancy.

Implications:

• This case demonstrates the feasibility and effectiveness of ERCP in managing gallstone pancreatitis during pregnancy.
• Early intervention can mitigate feto-maternal risks associated with acute pancreatitis.
• Further discussion on etiopathogenesis, diagnosis, and treatment strategies is crucial for optimizing outcomes.