Aurora Health Care

Internal Medicine Residency Program

Presentation Notes

Poster presented at 2018 APC Wisconsin Chapter Annual Scientific Meeting; September 7, 2018; Wisconsin Dells, WI.


Introduction: Pancreatitis is a commonly seen problem in the hospital setting. Many patients present with acute epigastric abdominal pain that may or may not radiate to the back. Workup generally consists of making the diagnosis with elevated lipase levels or imaging, and then determining the exact cause of the acute inflammation. Most commonly, clinicians look towards gall stones and alcohol use, and perhaps less commonly, hypertriglyceridemia, and medications. This case study will introduce a patient with a slightly more complex etiology. Case Presentation: A 28 year old male with no known past medical history presents with acute onset epigastric abdominal pain after a weekend of binge drinking, and using cocaine. He complained of associated nausea and vomiting. He also endorsed increased thirst over the last 1 month. He noted drinking water until he was full, but still felt thirsty. On his admission, notable lab findings were a lipase of 6499, blood glucose of 397, anion gap of 22, and a triglyceride level of 3122. CT abdomen had findings consistent with moderate pancreatitis and no evidence of gallstones. Conclusion: Pancreatitis is a well-known disease and can be common in the inpatient setting. Although there are many common causes for pancreatitis, our patient had a slightly more complex event of inciting factors leading to his presentation. He had a history of binge drinking, presented with hypertriglyceridemia, and was also noted to be in DKA. There are not many studies outlining acute pancreatitis in the setting of severe dyslipidemia and DKA occurring concomitantly.

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