Prompt cesarean delivery in late pregnancy for hyperlipidemia-induced pancreatitis: a case report.

Acute pancreatitis in pregnancy is a rare complication with varying etiologies and significant maternal and fetal risks. Hypertriglyceridemia-induced acute pancreatitis poses unique diagnostic and management challenges due to pregnancy-associated metabolic and hormonal changes. We report the case of a 26-year-old pregnant woman at 39 weeks of gestation presenting with left upper abdominal pain and severe hypertriglyceridemia. Acute pancreatitis was suspected based on clinical symptoms and laboratory findings, including elevated triglycerides, amylase, and inflammatory markers. A swift decision for emergency cesarean section was made, leading to the rapid reduction in triglyceride levels. Postpartum, the patient developed severe pancreatitis with systemic inflammatory response syndrome and persistently elevated D-dimer levels, necessitating thromboprophylaxis. A multidisciplinary approach, including dietary interventions and low-molecular-weight heparin, successfully managed acute pancreatitis along with the thrombotic risks, and both mother and child were discharged in good condition. This case highlights the interplay between pregnancy-specific metabolic changes and hyperlipidemia-induced pancreatitis. It emphasizes the importance of prompt clinical decision-making, particularly in the absence of definitive imaging. Elevated D-dimer levels were a significant prognostic marker and necessitated vigilant monitoring and prophylactic measures to mitigate thrombotic complications. Timely cesarean delivery, multidisciplinary management, and proactive thromboprophylaxis are crucial in hypertriglyceridemia-induced acute pancreatitis in pregnancy to achieve favorable outcomes.