Case Report
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 2004; 10(24): 3691-3695
Published online Dec 15, 2004. doi: 10.3748/wjg.v10.i24.3691
Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia
Yoshifumi Okura, Kozo Hayashi, Tetsuji Shingu, Goro Kajiyama, Yoshiyuki Nakashima, Keijiro Saku
Yoshifumi Okura, Yoshiyuki Nakashima, Division of Internal Medicine, Fukuoka Dental College Hospital, Fukuoka, Japan
Kozo Hayashi, Tetsuji Shingu, Goro Kajiyama, First Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan
Keijiro Saku, Division of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Yoshifumi Okura, Division of Cardiology, Department of Internal Medicine, Fukuoka Dental College Hospital, 2-15-1, Tamura, Sawara-ku, Fukuoka 814-0193, Japan. okuray@college.fdcnet.ac.jp
Telephone: +81-92-801-0411 Fax: +81-92-801-0735
Received: January 2, 2004
Revised: April 7, 2004
Accepted: April 14, 2004
Published online: December 15, 2004
Abstract

We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis. Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist, exhibiting a relief of abdominal symptoms. As in the present cases with acute abdomen following the ingestion of fatty food, the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen, when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.

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