Open AccessAcute pancreatitis associated with hypercalcaemia
Author(s) -
Mauro Enrique Tun-Abraham,
Gabriela Obregón-Guerrero,
Larry Romero-Espinoza,
Javier Valencia-Jiménez
Publication year - 2015
Publication title -
cirugía y cirujanos
Language(s) - English
Resource type - Journals
ISSN - 2444-0507
DOI - 10.1016/j.circen.2015.09.026
Subject(s) - hypercalcaemia , medicine , acute pancreatitis , pancreatitis , primary hyperparathyroidism , parathyroid hormone , hyperparathyroidism , scintigraphy , gastroenterology , parathyroid adenoma , radiology , calcium
BackgroundHypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5–8%. There is no clear pathophysiological basis, but elevated parathyroid hormone and high serum calcium levels could be responsible for calcium deposit in the pancreatic ducts and activation of pancreatic enzymes, which may be the main risk factor for developing acute pancreatitis. The aim of this report is to describe four cases.Clinical caseFour cases are reported of severe pancreatitis associated with hypercalcaemia secondary to primary hyperparathyroidism; three of them were with complications (two pseudocysts and one pancreatic necrosis). Cervical ultrasound, computed tomography, and scintigraphy, using 99mTc-Sestambi, studies showed the parathyroid adenoma. Surgical resection was the definitive treatment in all four cases. None of the patients had recurrent acute pancreatitis events during follow-up.ConclusionsAcute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques, such as cervical ultrasound, computed tomography, and scintigraphy, using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results