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🌱 Beginner Level — 0 / 50
Acute Pancreatitis in Pregnancy — Resuscitation, Etiology, and Early Enteral Nutrition
A 29-year-old at 26 weeks presents with severe epigastric pain radiating to the back, amylase/lipase >3× ULN, and ultrasound showing gallstones. Triglycerides 980 mg/dL. Outline stepwise management.
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Identify cause: RUQ ultrasound first-line; MRCP if choledocholithiasis suspected; avoid routine CT
Assess severity (vitals, AKI, hypoxemia) and maternal–fetal risks; admit/ICU as indicated
Gallstones: early ERCP if cholangitis/obstruction; interval laparoscopic cholecystectomy (2nd trimester ideal). Hypertriglyceridemia: insulin infusion ± plasmapheresis if severe
Begin early enteral feeding (NG/NJ) once pain improves; avoid prophylactic antibiotics unless infected necrosis
Early aggressive IV lactated Ringer’s, analgesia, antiemetics; NPO initially
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