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Related Experiment Videos

Pancreatic involvement associated with tricyclic overdose

R Pezzilli1, R Melandri, B Barakat

  • 1Emergency Department, Sant'Orsola Hospital, Bologna, Italy.

Italian Journal of Gastroenterology and Hepatology
|October 28, 1998
PubMed
Summary

Tricyclic antidepressant overdose can cause pancreatic involvement, indicated by elevated amylase and lipase levels. Monitoring these enzymes is crucial for early detection in overdose cases.

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Area of Science:

  • Toxicology
  • Gastroenterology
  • Internal Medicine

Background:

  • Tricyclic antidepressant (TCA) overdose is a serious clinical condition.
  • Pancreatic involvement is a rare complication of TCA overdose, with limited literature.
  • This case adds to the understanding of TCA-induced pancreatic injury.

Observation:

  • A 30-year-old female ingested 800 mg of amitriptyline.
  • Elevated serum amylase and lipase levels were observed on hospital day two.
  • Initial ultrasonography showed a normal pancreas, with no changes on follow-up.

Findings:

  • Serum pancreatic enzymes peaked on day four and gradually decreased.
  • Despite elevated enzymes, pancreatic imaging remained normal throughout hospitalization and follow-up.

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  • The patient recovered fully and was discharged eight days after admission.

    • Implications:

    • Routine monitoring of serum pancreatic enzymes (amylase and lipase) is recommended in patients presenting with TCA overdose.
    • Early detection of pancreatic involvement can guide clinical management.
    • This case highlights the importance of considering pancreatitis in TCA overdose patients, even with normal imaging.