Gallstone and Severe Hypertriglyceride-Induced Pancreatitis in Pregnancy
| Autor: | Benjamin Wilcox, Jerome Yankowitz, John C. Smulian, Jeremy Ellis, Mary Ashley Cain, Marc A. Vengrove |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Gallstones Gastroenterology Pregnancy Recurrence Internal medicine Hyperlipidemia medicine Humans Cholecystectomy Cholangiopancreatography Endoscopic Retrograde Hypertriglyceridemia Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry food and beverages Obstetrics and Gynecology General Medicine medicine.disease Surgery Pregnancy Complications Pancreatitis Acute Disease Acute pancreatitis Fluid Therapy Female Analgesia business |
| Zdroj: | Obstetricalgynecological survey. 70(9) |
| ISSN: | 1533-9866 |
| Popis: | Importance Patients with biliary disease or underlying dyslipidemias are at risk for pancreatitis in pregnancy. Appropriate treatment can decrease the risk of recurrence and perinatal complications. Prevention of severe lipid elevations can prevent the development of pancreatitis in pregnancy. Objective To review the pathophysiology, diagnosis and treatment of gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy. Evidence acquisition We performed a literature search regarding pancreatitis, gallstones, hyperlipidemia, and the treatment of both severe hypertriglyceride-induced pancreatitis and gallstone pancreatitis in pregnancy. Results In the setting of acute pancreatitis, removal of the offending agent, either gallstones or serum lipids, can lead to improved status and decrease recurrence risk. Conclusions and relevance Patients with acute pancreatitis should be treated with analgesia and fluid resuscitation and maintain a nothing-per-os status. In cases of gallstone pancreatitis, removal of the offending stone through endoscopic retrograde cholangiopancreatography or cholecystectomy can decrease recurrence risk. Severe hypertriglyceride-induced pancreatitis includes similar management. Lipopheresis may be considered in refractory cases. Patients with severe hypercholesterolemia should maintain a low-fat diet and can continue lipid-lowering agents outside the statin class of medications. Preventing severe dyslipidemia in gestation can decrease the risk of pancreatitis and improve maternal and neonatal outcomes. |
| Databáze: | OpenAIRE |
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