Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 1 , Pages 64-67, March 2007

Acute Necrotizing Pancreatitis Complicating Uteroplacental Apoplexy

  • Chong-U Cheang

      Affiliations

    • Department of Obstetrics and Gynecology, Kiang Wu Hospital, Macau, Taiwan
    • Department of Obstetrics and Gynecology, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Sai-Wai Ho

      Affiliations

    • Department of Emergency Medicine, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Yi-Torng Tee

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Chi-Feng Su

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Chi-Feng Su, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kao North Road, Taichung 402, Taiwan
    • ,
  • Gin-Den Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Medical University, Chung Shan Medical University Hospital, Taichung, Taiwan

Accepted 25 September 2006.

Article Outline

Summary 

Objective

Abruptio placentae induced by acute pancreatitis during pregnancy is very rare. We present a pregnant woman with a series of complications due to acute necrotizing pancreatitis.

Case Report

Presented herein is a 21-year-old, nulliparous woman at 33 weeks' gestation. The initial episode of abdominal pain was thought to be acute appendicitis (which in actuality was identified to be acute pancreatitis) and was complicated with abruptio placentae, uteroplacental apoplexy, and intrauterine fetal demise. Sterile necrotizing pancreatitis was confirmed by computerized axial tomography and total negativity of bacterial cultures taken from blood and ascites during the hospitalization. Nonsurgical management with conservative treatment was employed and the patient recovered gradually.

Conclusion

Acute pancreatitis is difficult to diagnose during pregnancy. It presents as a systemic inflammatory response syndrome resulting in hemodynamic changes and may lead to abruptio placentae. Nonsurgical conservative treatment may be useful in such patients.

Key Words:  abruptio placentae , acute necrotizing pancreatitis , intrauterine fetal demise , pregnancy , uteroplacental apoplexy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Corlet RC , Mishell DR . Pancreatitis in pregnancy . Am J Obstet Gynecol . 1972;113:281–290
  2. Steinberg W , Tenner S . Acute pancreatitis . N Engl J Med . 1994;330:1198–1210
  3. Block P , Kelly TR . Management of gallbladder stone pancreatitis during pregnancy and the postpartum period . Surg Gynecol Obstet . 1989;168:426
  4. Wikinson EJ . Acute pancreatitis in pregnancy: a review of 98 cases and a report of 8 new cases . Obstet Gynecol Surv . 1973;28:281–303
  5. Ramin KD , Ramin SM , Richey SD , Cunningham FG . Acute pancreatitis in pregnancy . Am J Obstet Gynecol . 1995;173:187–191
  6. Pritchard JA , Cunningham FG , Pritchard SA , Mason RA . On reducing the frequency of severe abruptio placentae . Am J Obstet Gynecol . 1991;165:1345–1351
  7. Pagliari M . On an unusual case of uterine apoplexy preceded by an acute necrosis of the pancreas . Quad Clin Ostet Ginecol . 1962;17:589–594
  8. Kramer MS , Usher RH , Pollack R , Boyd M , Usher S . Etiologic determinants of abruptio placentae . Obstet Gynecol . 1997;89:221–226
  9. Slutsker L . Risks associated with cocaine use during pregnancy . Obstet Gynecol . 1992;79:778–789
  10. Norman J . The role of cytokines in pathogenesis of acute pancreatitis . Am J Surg . 1998;175:76–83
  11. Beger HG , Bittner R , Buchler M , et al.   Hemodynamic data pattern in patients with acute pancreatitis . Gastroenterology . 1986;90:74–79
  12. Knoefel WT , Kollias N , Warshaw AL , et al.   Pancreatitis microcirculatory changes in experimental pancreatitis of graded severity in the rat . Surgery . 1994;116:904–913
  13. Beger HG , Rau B , Mayer J , Pralle U . Natural course of acute pancreatitis . Word J Surg . 1997;21:130–135
  14. Buchler MW , Gloor B , Muller CA , Friess H , Seiler CA , Uhl W . Acute necrotizing pancreatitis: treatment strategy according to the status of infection . Ann Surg . 2000;232:619–626
  15. Sainio V , Kemppainen E , Puolakkainen P , et al.   Early antibiotic treatment in acute necrotizing pancreatitis . Lancet . 1995;346:663–667
  16. Bassi C , Falconi M , Talamini G , et al.   Controlled clinical trial of pefloxacin versus impenem in severe acute pancreatitis . Gastroenterology . 1998;115:1513–1517
  17. Scott LD . Gallstone disease and pancreatitis in pregnancy . Gastroenterol Clin North Am . 1992;21:803–815

PII: S1028-4559(08)60110-2

doi:10.1016/S1028-4559(08)60110-2

Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 1 , Pages 64-67, March 2007

Article Tools