1/16. Gestational hyperlipidemic pancreatitis without non-gestational hyperlipidemia.A 27 year-old pregnant woman was referred to our department with nausea, abdominal pain, and hypertriglyceridemia (5500 mg/dl). A diagnosis of acute gestational hyperlipidemic pancreatitis was made. She had no history of nongestational hyperlipidemia. Subsequently, she underwent pancreatic drainage and Caesarean section. Our experience suggests that gestational hyperlipidemic pancreatitis may occur in pregnant women without nongestational hyperlipidemia. Intensive monitoring of serum lipid levels is mandatory when managing pregnant women who develop or show gestational worsening of hypertriglyceridemia.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/16. Necrotizing pancreatitis during pregnancy: a rare cause and review of the literature.Acute pancreatitis is an uncommon cause of abdominal pain during pregnancy, and rarely progresses to the necrotizing from of the disease in this clinical setting. Hyperlipidemia is an infrequent cause of acute pancreatitis. Whereas only 100 cases of hyperlipidemia-induced necrotizing pancreatitis have been reported in the literature to date, all of the cases were mild in severity and responsive to conservative medical management. Herein we present a case of life-threatening necrotizing pancreatitis, which developed in a hyperlipidemic pregnant woman and required multiple peripartum pancreatic necrosectomies. Additionally, we review the evaluation of pregnant patients with abdominal pain, the pathophysiology of hyperlipidemia-induced necrotizing pancreatitis, and the operative care of this challenging group of patients, revisiting an innovative technique for management of the retroperitoneum.- - - - - - - - - - ranking = 1.0730402378485keywords = pregnancy (Clic here for more details about this article) |
3/16. Neonatal diabetes with hyperchylomicronemia.Neonatal diabetes mellitus (NDM) is defined as hyperglycemia occurring in the first few weeks of life. It can be either transient (TNDM) or permanent (PNDM). A 25 days old newborn was brought to the hospital with restlessness, respiratory depression and cyanosis. He was born at term with a birth weight of 2,000 g. There was no consanguinity between his parents. His physical examination findings were as follows: Weight and height were under 3th percentile, he was hypoactive and dehydrated. serum glucose level was 800 mg/dl; c-peptide was 0.41 ng/ml. Upon investigation for dyslipidemia in association with his neonatal diabetes, hyperchylomicronemia was found both in the patient and his father. pancreatitis, anemia and cholestasis were also observed. insulin treatment was started for his diabetes together with a special diet for dyslipidemia. At the end of 28 months of follow-up, dyslipidemia has resolved but the need for insulin therapy was still existing. However, TNDM was considered in differential diagnosis because he was small for gestational age (SGA) at birth and his symptoms had started at the 25th day of the neonatal period. Delayed recovery from insulin dependency brought out the possibility of PNDM. Furthermore, neonatal diabetes combined with hypechylomicronemia is a rare clinical picture. Reported cases of NDM with different clinical evaluation will help to better understanding of this disorder.- - - - - - - - - - ranking = 0.11111111111111keywords = gestation (Clic here for more details about this article) |
4/16. Hyperlipemic pancreatitis and pseudocyst formation in late pregnancy.Hyperlipemic pancreatitis and pseudocyst formation late in pregnancy is a rare event. We report a case of hyperlipemic pancreatitis occurring in a G1P0 oriental woman at 32 weeks gestation. The initial serum lipase level was 1070 U/L, serum cholesterol level was 38.50 mmol/L and triglyceride level was > 57 mmol/L. She was treated conservatively with fasting, narcotic analgesia, and fluid resuscitation. Her symptoms resolved rapidly and lipase returned to normal within 2 days. During the first week in hospital she developed peripancreatic fluid collections and became symptomatic from a collection that extended down into the right pelvis. One week after admission she developed pre-term labor and delivered a healthy infant vaginally. There was an excellent outcome for both mother and infant. serum lipid levels returned to near normal by 6 weeks post delivery.- - - - - - - - - - ranking = 1.1841513489596keywords = pregnancy, gestation (Clic here for more details about this article) |
5/16. Use of lipid-lowering agents (statins) during pregnancy.QUESTION: A 34-year-old patient of mine is taking a 'statin' for hyperlipidemia. She is planning pregnancy and is worried about the safety of the drug. How should I advise her? ANSWER: Limited evidence from animal and human studies indicates that statins should not be taken during pregnancy. If a patient is inadvertently exposed during pregnancy, however, termination does not appear to be medically indicated.- - - - - - - - - - ranking = 1.5022563329879keywords = pregnancy (Clic here for more details about this article) |
6/16. Total parenteral nutrition in management of hyperlipidemic pancreatitis during pregnancy.OBJECTIVE: To describe a case of severe gestational hyperlipidemic pancreatitis successfully managed with minimal-lipid-containing parenteral nutrition (PN) followed by a minimal-fat diet, which resulted in delivery of a healthy full-term neonate. methods: We present the case of a young woman with gestational hyperlipidemic pancreatitis whose management included the use of PN during pregnancy. In addition, we review the literature pertaining to the management of hyperlipidemic pancreatitis during pregnancy and discuss the role for PN. RESULTS: A 32-year-old gravida 2, para 1 woman at 27 weeks 3 days of gestation presented with 1 day of nausea, bilious emesis, and severe abdominal pain caused by pancreatitis attributable to hypertriglyceridemia. Her initial serum triglyceride concentration was 9,450 mg/dL. She received fluids intravenously and minimal-lipid PN until resolution of her symptoms. The serum triglyceride level remained less than 850 mg/dL during administration of PN. She subsequently tolerated a minimal-fat diet, while the serum triglyceride level was maintained at less than 1,400 mg/dL, until delivery of a full-term, healthy neonate. CONCLUSION: In severe gestational hyperlipidemic pancreatitis, PN offers a safe and flexible treatment option by providing pancreatic rest and controlling serum triglyceride concentrations while maintaining fetal and maternal nutritional support.- - - - - - - - - - ranking = 1.7320927298626keywords = pregnancy, gestation (Clic here for more details about this article) |
7/16. Caring for a woman at high risk for type 2 diabetes.Women who are obese with a history of gestational diabetes are at risk for developing type 2 diabetes and metabolic syndrome. A weight loss of as little as 15 pounds can decrease these long-term risks. This case presentation reviews practical issues related to encouraging women to make important lifestyle changes and to adhere to taking cholesterol-lowering medications.- - - - - - - - - - ranking = 0.11111111111111keywords = gestation (Clic here for more details about this article) |
8/16. Hyperlipidemia and pregnancy associated pancreatitis with reference to plasma exchange as a therapeutic intervention.A 23 year old pregnant woman presented in her third trimester with severe pancreatitis and hyperlipidemia. Initial investigations suggested that her pancreatitis was induced by profound hypertriglyceridemia, which was the result of an underlying Fredrickson's V type hyperlipoproteinemia exacerbated by pregnancy. Concern for the life of the fetus prompted a caesarean operation and then drainage procedure for pancreatitis. plasma exchange, carried out to lower the levels of lipids and the pancreatic enzymes, improved the signs and symptoms of the patient. plasma exchange may be of great use in the management of hyperlipidemic pancreatitis.- - - - - - - - - - ranking = 1.0730402378485keywords = pregnancy (Clic here for more details about this article) |
9/16. Fat embolism and osteonecrosis.Clinical and experimental data accumulated within the past 2 decades explain the relationship between fat embolism and osteonecrosis, which now appears to be more causal than coincidental. Evidence for fatty liver, coalescence of endogenous plasma lipoproteins, and/or disruption of depot or marrow fat, all resulting in continuous or intermittent fat embolism, is related to 13 different clinical conditions associated with osteonecrosis, most recently including pregnancy, carbon tetrachloride poisoning, and possibly legg-calve-perthes disease. Intraosseous fat embolism, then, appears to trigger a three-phase thrombotic process of focal intravascular coagulation that results in osteonecrosis.- - - - - - - - - - ranking = 0.21460804756969keywords = pregnancy (Clic here for more details about this article) |
10/16. The effect of pregnancy and two different contraceptive pills on serum lipids and lipoproteins in a woman with a type III hyperlipoproteinaemia pattern.We report a woman who had a moderate elevation of serum triglycerides with a type III pattern of hyperlipoproteinaemia when taking a normal diet. She developed eruptive xanthomata with a grossly raised serum triglyceride concentration and chylomicronaemia when pregnant and also when taking a combined oral contraceptive pill containing 50 microgram of oestrogen. The xanthomata cleared and the triglyceride level fell when the combined oral contraceptive pill was changed to one with a lower oestrogen content, clofibrate was prescribed and the diet was restricted in carbohydrate and fat. Persistent chylomicronaemia is a serious complication of pregnancy because of the risk of pancreatitis and the potential risk of fetal malnutrition. Treatment with diet and clofibrate is indicated. High oestrogen-containing contraceptive pills appear to be contraindicated in patients with type III or other hypertriglyceridaemic states.- - - - - - - - - - ranking = 1.0730402378485keywords = pregnancy (Clic here for more details about this article) |
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