Gallbladder sludge in a pregnant woman as a cause of severe complicated hemorrhagic-necrotizing pancreatitis with a spectacular manifestation

Abstract

Pancreatitis is an obvious but a rare event in pregnancy. From mild disease to multiorgan failure and sepsis acute pancreatitis has numerous causes and an often unpredictable outcome. The authors present a case of 22-year-old pregnant woman with severe pancreatitis due to biliary sludge. An unusual clinical manifestation of pancreatitis in our patient is worth emphasizing: massive bleeding from upper alimentary tract and concomitant two pancreatic fistulas. The bleeding is a manifestation of the pancreatic juiceinduced injury to the splenic artery, whereas the fistulas are consequence of the disconnected duct syndrome and superficial necrosis of the pancreatic head. After two and a half years lasting treatment the patient was on regular oral diet with supplementation of pancreatic enzymes, and showed normal glycaemia level. She returned to fully physical activity.