November 12, 2014
Notes: Das, Stephanie L M
Singh, Primal P
Phillips, Anthony R J
Windsor, John A
Petrov, Maxim S
Gut. 2014 May;63(5):818-31. doi: 10.1136/gutjnl-2013-305062. Epub 2013 Aug 8.
Author Address: Department of Surgery, The University of Auckland, , Auckland, New Zealand.
Reference Type: Journal Article
Record Number: 5021Author: Degardin, J., Pons, B., Ardisson, F., Gallego, J. P. and Thiery, G.
Title: [Multiple organ failure complicating a severe acute necrotising pancreatitis secondary of a severe hypertriglyceridemia: a case report]
Journal: Ann Fr Anesth Reanim
Short Title: [Multiple organ failure complicating a severe acute necrotising pancreatitis secondary of a severe hypertriglyceridemia: a case report]
Alternate Journal: Annales francaises d’anesthesie et de reanimation
ISSN: 1769-6623 (Electronic)
Original Publication: Defaillance multiviscerale compliquant une pancreatite aigue au decours d’une hypertriglyceridemie majeure: a propos d’un cas.
Accession Number: 23948029
Keywords: Acute Kidney Injury/complications/therapy
Glasgow Coma Scale
Multiple Organ Failure/*complications/therapy
Pancreatitis, Acute Necrotizing/*complications/etiology/therapy
Respiratory Distress Syndrome, Adult/complications/therapy
Tomography, X-Ray Computed
Abstract: We report the case of a 42-year-old man admitted for a multi-organ failure with a coma, a hemodynamic instability, a respiratory distress syndrome, an acute renal failure and a thrombocytopenia. The blood samples highlighted a milky serum and allowed to diagnose an acute pancreatitis associated with a major dyslipidemia: hypertriglyceridemia 11,800 mg/dL and hypercholesterolemia 1195 mg/dL. The CT-scans do not reveal any cerebral abnormalities but highlighted pancreatic lesions without biliary obstruction. A multi-organ failure complicating a severe acute pancreatitis secondary of a major hypertriglyceridemia was mentioned. Despite the absence of clear guidelines, a session of plasma exchange was started in emergency. Symptomatic treatment with protective ventilation, vasopressors, continuous heparin and insulin was continued. The clinical and biological course was good in parallel of the normalization of lipid abnormalities. The patient was discharged at day 17 with a lipid-lowering therapy. We discuss the various treatments available for the management of acute pancreatitis complicating a severe hypertriglyceridemia and their actual relevance in the absence of clear recommendations.