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Case Report

Acute pancreatitis and pregnancy: A rare and severe association

Hicham Chemsi, Nabiha Kamal.


Introduction Acute pancreatitis associated with pregnancy is a serious condition, surgical discovery or even necropsy and difficult diagnosis. We report a case of acute pancreatitis occurring in a pregnant woman.
Observation This is a 29-year-old woman, nulliparous with no previous pathological history, presented to obstetric emergencies for hepatic colic. The patient had no transit disorder or gastrointestinal bleeding. Clinically, the patient was feverish, blood pressure was 16/9 mmHg and her hemodynamic status was stable. Obstetrical examination was normal, correlated with gestational age. The biological assessment performed showed anemia. The viral serology performed was negative. Liver status, renal status and coagulation status were normal. The diagnosis was acute pancreatitis and pre-eclampsia in pregnancy.
Discussion Acute pancreatitis rarely occurs during pregnancy. It is associated with high maternal and fetal mortality. It occurs in most cases in the 3rd trimester of pregnancy [1]. In the 2nd and 3rd trimesters, supersaturation of bile in relation to increased cholesterol excretion and stagnation of supersaturated bile in the gallbladder induces formation of cholesterol crystals and gallstones [2]. In the 3rd trimester, the gravid uterus compresses the common bile duct and can lead to acute pancreatitis. Acute pancreatitis during pregnancy may be associated with pre-eclampsia that increases fetal mortality [3].
Conclusion Acute pancreatitis during pregnancy is a rare association, difficult to diagnose and has a terrible prognosis for both the mother and the fetus. The diagnostic and therapeutic delay will be fatal to the mother-child couple.

Key words: Acute pancreatitis, pregnancy, severe association

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