Septic shock caused by postpartum acute pancreatitis, a case report and literature review
Abstract Introduction Postpartum acute pancreatitis (PAP) is a rare but potentially life-threatening condition that can occur following childbirth. The incidence of PAP is estimated to be between 1 in 1,000 and 1 in 10,000 deliveries, with a significant proportion of cases linked to biliary causes,...
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BMC
2025-03-01
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| Series: | International Journal of Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12245-025-00862-y |
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| author | Changiz Delavari Delaram J. Ghadimi Maryam Taheri Harsh Kumar Pouya Ebrahimi Amir Nasrollahizadeh Sepide Javankiani |
| author_facet | Changiz Delavari Delaram J. Ghadimi Maryam Taheri Harsh Kumar Pouya Ebrahimi Amir Nasrollahizadeh Sepide Javankiani |
| author_sort | Changiz Delavari |
| collection | DOAJ |
| description | Abstract Introduction Postpartum acute pancreatitis (PAP) is a rare but potentially life-threatening condition that can occur following childbirth. The incidence of PAP is estimated to be between 1 in 1,000 and 1 in 10,000 deliveries, with a significant proportion of cases linked to biliary causes, particularly gallstones and biliary sludge. Prompt diagnosis and comprehensive management are essential to prevent severe complications such as septic shock and peritonitis. Case presentation We report the case of a 25-year-old white woman who presented with severe abdominal pain and septic shock 18 days after a cesarean section. Initial management included aggressive fluid resuscitation, broad-spectrum antibiotics, and pain control. Diagnostic imaging and laboratory tests confirmed the presence of biliary obstruction due to gallstones and biliary sludge, leading to acute pancreatitis. An endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the biliary obstructions, followed by a laparoscopic cholecystectomy to prevent recurrence. Discussion PAP, while rare, poses significant risks and can lead to serious side effects such as septic shock. Early diagnosis by laboratory workup and imaging is essential. In this instance, gallstones and biliary sludge were found to be the culprit, requiring cholecystectomy and ERCP. ERCP was effective in this patient, despite its controversy in septic patients. The effective management of PAP requires a multidisciplinary approach involving obstetricians, gastroenterologists, surgeons, and critical care specialists. Conclusion PAP must be identified and treated as soon as possible. Bile obstruction is a common problem that necessitates prompt imaging and, if necessary, endoscopic or surgical intervention. Delays can be fatal; timing is crucial. To prevent deadly consequences, doctors must be extremely suspicious of postpartum patients presenting with abdominal pain. |
| format | Article |
| id | doaj-art-d22e502a70d24f06b75a34ec5df6c813 |
| institution | OA Journals |
| issn | 1865-1380 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj-art-d22e502a70d24f06b75a34ec5df6c8132025-08-20T01:57:51ZengBMCInternational Journal of Emergency Medicine1865-13802025-03-011811810.1186/s12245-025-00862-ySeptic shock caused by postpartum acute pancreatitis, a case report and literature reviewChangiz Delavari0Delaram J. Ghadimi1Maryam Taheri2Harsh Kumar3Pouya Ebrahimi4Amir Nasrollahizadeh5Sepide Javankiani6Department of Plastic Surgery, Imam Khomeini Hospital of Tehran, Tehran University of Medical SciencesSchool of Medicine, Shahid Beheshti University of Medical SciencesTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical SciencesLiaquat National Hospital and Medical CollegeTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical SciencesTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical SciencesDepartment of Plastic Surgery, Imam Khomeini Hospital of Tehran, Tehran University of Medical SciencesAbstract Introduction Postpartum acute pancreatitis (PAP) is a rare but potentially life-threatening condition that can occur following childbirth. The incidence of PAP is estimated to be between 1 in 1,000 and 1 in 10,000 deliveries, with a significant proportion of cases linked to biliary causes, particularly gallstones and biliary sludge. Prompt diagnosis and comprehensive management are essential to prevent severe complications such as septic shock and peritonitis. Case presentation We report the case of a 25-year-old white woman who presented with severe abdominal pain and septic shock 18 days after a cesarean section. Initial management included aggressive fluid resuscitation, broad-spectrum antibiotics, and pain control. Diagnostic imaging and laboratory tests confirmed the presence of biliary obstruction due to gallstones and biliary sludge, leading to acute pancreatitis. An endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the biliary obstructions, followed by a laparoscopic cholecystectomy to prevent recurrence. Discussion PAP, while rare, poses significant risks and can lead to serious side effects such as septic shock. Early diagnosis by laboratory workup and imaging is essential. In this instance, gallstones and biliary sludge were found to be the culprit, requiring cholecystectomy and ERCP. ERCP was effective in this patient, despite its controversy in septic patients. The effective management of PAP requires a multidisciplinary approach involving obstetricians, gastroenterologists, surgeons, and critical care specialists. Conclusion PAP must be identified and treated as soon as possible. Bile obstruction is a common problem that necessitates prompt imaging and, if necessary, endoscopic or surgical intervention. Delays can be fatal; timing is crucial. To prevent deadly consequences, doctors must be extremely suspicious of postpartum patients presenting with abdominal pain.https://doi.org/10.1186/s12245-025-00862-yPostpartum acute pancreatitisBiliary obstructionGallstonesSeptic shock |
| spellingShingle | Changiz Delavari Delaram J. Ghadimi Maryam Taheri Harsh Kumar Pouya Ebrahimi Amir Nasrollahizadeh Sepide Javankiani Septic shock caused by postpartum acute pancreatitis, a case report and literature review International Journal of Emergency Medicine Postpartum acute pancreatitis Biliary obstruction Gallstones Septic shock |
| title | Septic shock caused by postpartum acute pancreatitis, a case report and literature review |
| title_full | Septic shock caused by postpartum acute pancreatitis, a case report and literature review |
| title_fullStr | Septic shock caused by postpartum acute pancreatitis, a case report and literature review |
| title_full_unstemmed | Septic shock caused by postpartum acute pancreatitis, a case report and literature review |
| title_short | Septic shock caused by postpartum acute pancreatitis, a case report and literature review |
| title_sort | septic shock caused by postpartum acute pancreatitis a case report and literature review |
| topic | Postpartum acute pancreatitis Biliary obstruction Gallstones Septic shock |
| url | https://doi.org/10.1186/s12245-025-00862-y |
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