Acute pancreatitis in pregnancy

Abstract

Acute pancreatitis (AP) is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated with greater concerns as it deals with two lives rather than just one as in the non-pregnant population. The recent advances in clinical gastroenterology have improved the early diagnosis and effective management of biliary pancreatitis. Diagnostic studies such as endoscopic ultrasound, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography and therapeutic modalities that include endoscopic sphincterotomy, biliary stenting, common bile duct stone extraction and laparoscopic cholecystectomy are major milestones in gastroenterology. When properly managed AP in pregnancy does not carry a dismal prognosis as in the past.

Prevalencia De Pancreatitis Aguda en El Embarazo

“…Una paciente de 32 años que presentó pancreatitis durante el primer trimestre, con cuadro remitido y resolución quirúrgica durante el segundo trimestre acudió a su control prenatal a las 37 semanas de gestación refiriendo ausencia de movimientos fetales y el embarazo terminó en un óbito. discusión La incidencia anual de la pancreatitis aguda es de 5 a 80 casos por cada 100.000 3 . En mujeres embarazadas se reporta desde 1 en 1.000 a 3 en 10.000 embarazos 3,6,7 .…”

“…discusión La incidencia anual de la pancreatitis aguda es de 5 a 80 casos por cada 100.000 3 . En mujeres embarazadas se reporta desde 1 en 1.000 a 3 en 10.000 embarazos 3,6,7 . En nuestro país existen pocos trabajos que traten la temática.…”

“…Se estima que la incidencia del abdomen agudo durante el embarazo es de 1 en 500-635 embarazos 1 siendo la apendicitis la causa más común, que corresponde al 25% de las indicaciones quirúrgicas no obstétricas durante la gestación. La incidencia de la pancreatitis varía aproximadamente de 1 en 1.000 a 1 en 10.000 nacimientos 3 . Los cambios fisiológicos asociados al embarazo incrementan el riesgo de presentar pancreatitis.…”

Postpartum Pancreatitis

“…Özellikle son trimesterde yüksek östrojen seviyelerine bağlı hepatik safra içeriği değişmekte, yüksek progesterona bağlı motilite azalmakta ve rezidü safra miktarı artmaktadır (8). Özellikle kolesterolden zengin süpersature rezidü safra, kolesterol kristallerine ve zaman geçtikçe taş oluşumuna neden olmaktadır (6). Gebelik süresince oluşan minik safta taşları veya çamur, doğumdan sonra yine safra kompozisyonu ve kese motilitesindeki değişikler yüzünden kaybolabilir.…”

Acute pancreatitis in pregnancy: An unresolved issue

“…We read with interest the article "Acute pancreatitis in pregnancy" by Pitchumoni et al [1] in December 7, 2009 issue of World Journal of Gastroenterology. We agree that recommendation for management of acute pancreatitis is based on expert opinion only, due to geographic and ethnic variations.…”