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Case Report
Postpartum acute pancreatitis in the setting of severe preeclampsia: Diagnostic challenges and surgical findings
1 Department Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA
2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA, USA
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Marie Elise Abi Antoun
800 Washington Street, Boston, MA 02111,
USA
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Article ID: 100080Z09MA2025
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Abi Antoun ME, Kassem Z, Cammock EC, Lee CM, Craigo S. Postpartum acute pancreatitis in the setting of severe preeclampsia: Diagnostic challenges and surgical findings. J Case Rep Images Med 2025;11(2):1–4.ABSTRACT
Introduction: Acute pancreatitis is a rare complication of pregnancy; however, it can be associated with significant maternal and fetal mortality. Suggestive symptoms mimic multiple pregnancy and postpartum conditions, making the diagnosis difficult. This case report highlights diagnostic challenges and imaging findings in a patient with severe preeclampsia whose postpartum course was complicated by acute pancreatitis.
Case Report: A reproductive-aged patient presented, in the late second trimester, for preeclampsia with severe features by blood pressure and creatinine. Worsening of maternal kidney function and fetal status required urgent cesarean delivery. The postoperative course was complicated by severe abdominal pain. On initial imaging, there was postoperative fluid without any significant intra-abdominal pathology. However, worsening of the clinical condition and development of an acute abdomen required an exploratory laparotomy. Intraoperative findings were significant for intra-abdominal ascites and extensive saponification of the omentum, concerning for acute pancreatitis. Testing of the ascitic fluid revealed an elevated lipase level at 5,319 U/L, and a retrospective serum lipase level was 2,109 U/L. Despite a normal appearance of the pancreas on computed tomography (CT) scan of the abdomen, laboratory findings were confirmatory of the diagnosis of acute pancreatitis. The patient then underwent multiple abdominal explorations with direct peritoneal resuscitation. Recovery was progressive and discharge occurred three weeks postpartum.
Conclusion: Although rare, acute pancreatitis can complicate the postpartum course, especially in the setting of severe preeclampsia. This case underscores diagnostic challenges due to overlapping presentations. It is important to keep a high index of suspicion for acute pancreatitis in the differentials of postpartum abdominal pain, as late recognition and management are associated with significant morbidity.
Keywords: Cesarean, Pancreatitis, Postpartum, Preeclampsia
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Acknowledgments
The authors acknowledge the use of open AI’s ChatGPT, version GPT-4, in some sections of the abstract. The technology was solely used to help with language refinement, grammar editing, and improving sentence structure of content written by the authors. The AI tool was not used to generate figures, tables, or novel data. All information and interpretations were generated by the research team and verified by the authors. The authors confirm that the content edited using AI tool was carefully reviewed and ensure accuracy and originality. The content is free from plagiarism.
Author ContributionsMarie Elise Abi Antoun - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zeinab Kassem - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Ethelin Camille Cammock - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Charlotte McIntosh Lee - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Sabrina Craigo - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Marie Elise Abi Antoun et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
