高脂血症を伴った重症急性膵炎の一救命例

Abstract

A case of severe acute pancreatitis with hyperlipidemia is reported. A 31 -year-old man was admitted to our hospital due to acute pancreatltls. The enhanced abdominal CT demonstrated diffuse enlargement of the pancreas with peripancreatic inflammatory changes and fluid collection. Laboratory da,ta showed elevation of Amylase, Triglyceride, Lactic dehydrogenase and Blood sugar. Thus, we diagnosed severe acute pancreatitis with hyperlipidemia and started arterial infusion of proteinase inhibitor. On the 33rd hospital day, we performed necrosectomy and closed wide pancreatic drainage because of infectious signs. Postoperatively, the drains were irrigated with saline solution on a daily basis and we continued arterial infusion of proteinase inhibitor. Hewever, severe pancreatitis was improved, Triglyceride was elevated. Very Low Density Lipoprotein was 362 mg/dl and Chylomicron was 532 mg/dl. Then, we diagnosed type V hyperlipidemia. However, acute pancreatitis with hyperlipidemia is not common and the relation between acute pancreatitis and hyperlipidemia is controversial ; we considered that the control of hyperlipidemia is important for preventing pancreatitis.