Acute pancreatitis mimicking hyperemesis gravidarum in the first trimester in young primigravida: diagnostic difficulty and a rare case report.

Introduction and importance: Acute pancreatitis (AP) in pregnancy is rare, and its symptoms often overlap with common conditions like hyperemesis gravidarum (HG), which complicates diagnosis. Early recognition and appropriate management can prevent significant maternal and fetal complications. Case presentation: A 21-year-old primigravida at 10 + 6 weeks of gestation presented with the acute onset of abdominal pain in the epigastric region and multiple episodes of vomiting. She was provisionally diagnosed with HG, but further investigation revealed elevated serum lipase and amylase levels, leading to a diagnosis of AP. She was admitted to the intensive care unit for a multidisciplinary approach. The woman was finally discharged with stable vitals. Case discussion: In pregnant patients, severe HG symptoms can sometimes mask or co-occur with AP. Symptoms like severe abdominal pain and vomiting can overlap. Our patient presented with such symptoms, and it required thorough evaluation to reach our diagnosis and provide the appropriate care needed. Conclusion: This case highlights the importance of maintaining a high index of suspicion for pancreatitis in pregnant patients presenting with severe gastrointestinal symptoms, especially when the response to standard treatments for HG is suboptimal. Timely diagnosis and coordinated care are essential for optimizing outcomes.