Immunosuppressant-induced late acute pancreatitis after laparoscopic sleeve gastrectomy: a case report and literature review

Abstract

Acute pancreatitis (AP) is a serious life-threatening condition, especially in high-risk patients. Limited data exist regarding early and late complications of immunosuppressant drugs as a cause of pancreatitis, especially Tacrolimus and Mycophenolate Mofetil (MMF), after transplantation. We report a rare case of late AP secondary to immunosuppressants’ synergistic effect after 5 years of renal transplant in an obese patient on day 4 after laparoscopic sleeve gastrectomy (LSG). We present a 41-year-old Saudi obese male patient, known to have multiple comorbidities and a renal transplantation twice, was on multiple medications, including Prednisolone, MMF and Tacrolimus for 5 years. On day 4 post-LSG, he developed severe epigastric abdominal pain and was diagnosed to have AP as a late complication of immunosuppressants’ synergistic effect. LSG is a common safe procedure, but complications related to medical illnesses or medications can occur. Careful review and sufficient knowledge of early and late complications are required.