Management of hypertriglyceridemia induced acute pancreatitis in emergency department

Aim: In this report, we aimed to share our experience on the treatment of hypertriglyceridemia induced acute pancreatitis (HTGIAP). Materials and Methods: Between October 2015-October 2016, treatment protocols and lipase, amylase and triglyceride levels of the patients who admitted to our emergency department (ED) and diagnosed as HTGIAP were included in the study. Patients’ basal and after 24 hours lipase, amylase and trigelyceride results and clinical findings were also recorded. Results: During the study period, 142.482 patients were admitted to our emergency department. Of this overall number, 370 patients were diagnosed as acute pancreatitis (AP). Among these patients, the mean age of 10 patients who were diagnosed with HTGAP was 36.2±19.8 and six of them were female. Seven of these patients had a history of hyperlipidemia, 6 had diabetes mellitus, 2 had hypothyroidism and 6 patients had a prior acute pancreatitis attack. In ED, after the diagnosis of HTGIAP, insulin infusion treatment was started to all the patients. Average follow-up time in the ED is about one day and after 24 hours, severity of clinical signs were regressed and levels of triglyceride, amylase, and lipase were decreased in all patients. Conclusion: Emergency physicians should kept hypertriglyceridemia in mind in differential diagnosis of acute pancreatitis. To reduce the complication rate in patients who diagnosed as HTGIAP in the ED, early treatment protocol should be applied. Insulin infusion treatment may be preferred as first choice in these cases, because it is more practical and is easier to follow than apheresis treatment in the ED conditions.