Acute Pancreatitis During Pregnancy, 7-Year Experience of a Tertiary Referral Center

IntroductionAcute pancreatitis is a common cause of acute abdomen in pregnant women. The purpose of this study was to determine the frequency at our institution and its management and outcomes.MethodsA retrospective analysis of a database of cases presented in 7 consecutive years at a tertiary center was performed.ResultsBetween December 2002 and August 2009, there were 19 cases of acute pancreatitis in pregnant women, 85% with a biliary etiology. The highest frequency was in the third trimester of pregnancy (62.5% cases). In cases of gallstone pancreatitis, 43.6% of pregnant women had previous episodes before pregnancy. A total of 52.6% of the patients were readmitted for a recurrent episode of pancreatitis during their pregnancy. Overall, 26.3% of the patients received antibiotic treatment and 26.3% parenteral nutrition. Laparoscopic cholecystectomy was performed during the 2nd trimester in two patients (10.5%). There was no significant maternal morbidity.ConclusionAcute pancreatitis in pregnant women usually has a benign course with proper treatment. In cases of biliary origin, it appears that a surgical approach is suitable during the second trimester of pregnancy.

ResumenIntroducciónLa pancreatitis aguda es causa frecuente de abdomen agudo en gestantes. El objetivo era conocer la frecuencia en nuestro centro, así como su manejo y resultados.MetodologíaAnálisis retrospectivo de los casos presentados en 7 años consecutivos, buscando en la base de datos de un centro de tercer nivel.ResultadosEntre diciembre de 2002 y agosto del 2009, hubo 19 casos de pancreatitis aguda en gestantes, el 85% de ellos de etiología biliar. La mayor frecuencia era en el tercer trimestre (62,5% casos). En los casos de pancreatitis litiásica, el 43,6% de las gestantes habían presentado episodios previos al embarazo. El 52,6% reingresaron por una recidiva del episodio de pancreatitis. Recibieron tratamiento antibiótico el 26,3%, y nutrición parenteral otro 26,3%. Se intervino de colecistectomía laparoscópica durante el segundo trimestre a 2 pacientes (10,5%). No hubo morbimortalidad maternoinfantil significativa.ConclusiónLa pancreatitis en gestantes suele tener una evolución benigna con el tratamiento adecuado. En los casos de origen biliar, parece seguro intervenir durante el segundo trimestre de gestación.