Korean J Gastroenterol.  2016 Sep;68(3):161-165. 10.4166/kjg.2016.68.3.161.

A Case of Idiopathic Severe Acute Pancreatitis following Cesarean Section Delivery

• Kim J
• Choi JH
• Shin BS
• Nam JY
• Kang EA
• Kim JS
• Hwang JH
• Kim J

• KMID: 2358720
• DOI: http://doi.org/10.4166/kjg.2016.68.3.161

Abstract

Acute pancreatitis rarely occurs in the postpartum period. Furthermore, there are very few reports of it after cesarean section delivery. A 35-year-old woman presented with dyspnea and abdominal distension on the third day after cesarean section delivery. Under a suspicion of acute pancreatitis, she was initially managed with conservative treatment. However, she developed intra-abdominal fluid collections and gastric bleeding, which were managed with percutaneous drainage, endoscopic hemostasis, and angiographic embolization. She was discharged with good clinical recovery. Postpartum pancreatitis, especially after cesarean section, is rare; however, its management is not different from that for usual pancreatitis.

Keyword

Pancreatitis; Postpartum period; Cesarean section; Gastric varix; Stomach ulcer

MeSH Terms

Adult
Cesarean Section*
Drainage
Dyspnea
Esophageal and Gastric Varices
Female
Hemorrhage
Hemostasis, Endoscopic
Humans
Pancreatitis*
Postpartum Period
Pregnancy
Stomach Ulcer

Figure

• 

  Fig. 1. CT reveals pancreatic swelling and abdominal fluid collection. (A) On axial CT scan, diffuse pancreatic swelling and slightly reduced parenchymal attenuation are seen, but no indication of pancreatic necrosis or duct dilatation. (B) On coronal CT scan, the peripancreatic area, retroperitoneal space, mesentery, and transverse mesocolon fluid collections are seen. In the omentum, mesentery, and peritoneum, diffuse infiltration is seen. (C) On axial CT scan, a small stone is seen in the gallbladder.

• 

  Fig. 2. CT of the abdomen reveals a considerable amount of fluid. On coronal CT scan, considerable fluid collection is seen in the peritoneal cavity and retroperitoneum. Accumulation of contrast enhancement is seen in the wall of the fluid collections, in keeping with tissue reaction and abscess formation.

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  Fig. 3. (A) An exposed vessel is present in the high body greater curvature anterior wall side. (B) Successfully installed hemoclips are shown.(C) Splenic vein obliteration (white arrow) is suspected on CT scan. (D) Histoacryl injection to the gastric varix is seen on the posterior wall side of the high body greater curvature. (E) Locations of posterior gastric artery pseudoaneurysm (black arrow) and left gastric artery angiographic embolization sites are shown.

Reference

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