Hypertriglyceridemia induced acute pancreatitis

We discussed a case of a man w/ HLD, IDDM2, Obesity, hx of pancreatitis, who presented to the hospital for acute epigastric pain, decreased PO intake, and non-bloody / non-bilious emesis. He was diagnosed with Hypertriglyceridemia-induced Acute Pancreatitis.
We discussed how to approach abdominal pain as well as pearls when treating hypertriglyceridemia-induced acute pancreatitis.
Framework for abdominal pain
  • R/o emergencies: obstruction, perforation, vascular, ectopic pregnancy.

Hypertriglyceridemia-induced acute pancreatitis

  • Triglycerides are broken down into free fatty acids that accumulate to toxic levels, which can cause inflammation of the pancreas.
  • Early (within ~48 hrs) enteral refeeding is encouraged.
    • Enteral (PO) feeding is recommended over parenteral (IV) to help maintain intestinal barrier and prevent bacterial translocation from the gut.
  • Insulin is used to treat hypertriglyceridemia-induced acute pancreatitis. Insulin promotes storage of triglycerides and inhibits breakdown of triglycerides into free fatty acids.

Hypertriglyceridemia induced acute pancreatitis Summary pdf

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