Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Case Report Volume 3 Issue 12

Acute Biliary Pancreatitis: A Preventable Cause of Maternal Death

Papa Dasari1*, Dhivya Balachandran2 and Priyadharshini R3

1Senior Professor, Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India

2Senior Resident, Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India

3Junior Resident, Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India

*Corresponding Author: Papa Dasari, Senior Professor, Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India.

Received: October 19, 2021; Published: November 29, 2021


A 29 year young multigravida at 35 weeks of pregnancy was provisional diagnosed as AFLP and underwent emergency LSCS for fetal distress and developed metabolic acidosis and required ventilator support and ICU care. USG revealed gall bladder sludge and she had large volume of biliary ascites. Her initial amylase and lipase were elevated on day postpartum day 2 and there was difference of opinion for undertaking ERCP. She was managed conservatively with higher broad spectrum antibiotics for sepsis and intraperitoneal drain for 21 days and by which time she improved but deteriorated after 2 days of removing the drain and consuming normal diet. Emergency Laparotomy on postnatal Day 30 revealed Pseudocyst of pancreas. Peritoneal fluid lipase and amylase were elevated 4-5 times and she subsequently developed MODS, gastroduodenal artery haemorrhage and shock. She was embolized successfully but succumbed.

Keywords: Pregnancy; Acute Biliary Pancreatitis; Gall Bladder Sludge; Pseudocyst; Gastroduodenal Artery Embolization; Maternal Mortality


  1. Eddy JJ., et al. “Pancreatitis in pregnancy”. Obstetrics and Gynecology 112 (2008): 1075-1081.
  2. Geng Y., et al. “Severe acute pancreatitis during pregnancy: eleven years’ experience from a surgical intensive care unit”. Digestive Diseases and Sciences 56 (2011): 3672-3677.
  3. Igbinosa O., et al. “Pregnancy associated pancreatitis revisited”. Clinics and Research in Hepatology and Gastroenterology 37 (2013): 177-181.
  4. Papadakis EP., et al. “Acute pancreatitis in pregnancy: an overview”. European Journal of Obstetrics and Gynecology and Reproductive Biology 2 (2011): 261-266.
  5. Luo L., et al. “Clinical characteristics of acute pancreatitis in pregnancy: experience based on 121 cases”. Archives of Gynecology and Obstetrics 2 (2018): 333-339.
  6. Abdullah B., et al. “Severe acute pancreatitis in pregnancy”. Case Reports in Obstetrics and Gynecology (2015): 239068.
  7. Zhong Y., et al. “Early diagnostic test for acute fatty liver of pregnancy: a retrospective case control study”. BMC Pregnancy Childbirth 20 (2020): 162.
  8. Ko CW., et al. “Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy”. Hepatology 41 (2005): 359-365.
  9. Banks PA., et al. “Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus”. Gut1 (2015): 102-111.
  10. Ducarme G., et al. “Acute pancreatitis during pregnancy: a review”. Journal of Perinatology 2 (2014): 87-94.
  11. Polydorou A., et al. “A multimodal approach to acute biliary pancreatitis during pregnancy: a case series”. Surgical Laparoscopy Endoscopy and Percutaneous Techniques 22 (2012): 429-432.
  12. Neoptolemos JP., et al. “Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones”. Lancet8618 (1988): 979-983.
  13. Fölsch UR., et al. “Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis”. The New England Journal of Medicine 4 (1997): 237-242.
  14. Bassi C., et al. “Early complications of severe acute pancreatitis”. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt (2001).
  15. Habashi S and Draganov PV. “Pancreatic pseudocyst”. World Journal of Gastroenterology 1 (2009): 38-47.
  16. K Novacic., et al. “Embolization of a large pancreatic pseudoaneurysm converted from pseudocyst (hemorrhagic pseudocyst)”. Journal of the Pancreas 3 (2008): 317-321.
  17. Sudhir Kumar Jain., et al. “Hemorrhagic Pseudocyst of Pancreas Treated with Coil Embolization of Gastroduodenal Artery: A Case Report and Review of Literature". Case Reports in Surgery 2015 (2015): 3.
  18. C Robins JB. “Internal haemorrhage resulting from erosion of a pancreatic pseudocyst-a unique cause of fatal postpartum collapse”. Journal of Obstetrics and Gynaecology 6 (2003): 674-677.
  19. Hot S., et al. “Acute biliary pancreatitis during pregnancy and in the post-delivery period”. Ulusal travma ve acil cerrahi dergisi 3 (2019): 253-258.


Citation: Papa Dasari., et al. “Acute Biliary Pancreatitis: A Preventable Cause of Maternal Death". Acta Scientific Women's Health 3.12 (2021): 25-32.


Copyright: © 2021 Papa Dasari., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US