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  • Case Study
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Biliary sludge and acute pancreatitis during pregnancy

Abstract

Background A 34-year-old Hispanic woman at 34 weeks' gestation presented with upper-abdominal pain, nausea, and vomiting of 1 day's duration. She had no active medical problems and had undergone two prior Caesarean sections. Laboratory tests revealed elevated serum amylase and lipase levels. Ultrasonography demonstrated gallbladder sludge without gallstones, gallbladder wall thickening, or bile-duct dilatation.

Investigations Physical examination and laboratory tests of serum amylase, lipase, bilirubin, alkaline phosphatase, and transaminase levels. Abdominal ultrasonography.

Diagnosis Biliary sludge and acute pancreatitis.

Management The patient was managed conservatively with narcotic pain control, intravenous hydration, nutritional support, and fetal monitoring. She subsequently underwent an uncomplicated Caesarean section. Laparoscopic cholecystectomy was performed 8 weeks postpartum.

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Figure 1: Gallbladder ultrasound in a 34-year-old woman at 34 weeks' gestation.
Figure 2: Gallbladder ultrasound in a 19-year-old nonpregnant woman showing high-amplitude echoes within the gallbladder consistent with small gallstones (white arrow).

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Correspondence to Cynthia Ko.

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The author declares no competing financial interests.

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Ko, C. Biliary sludge and acute pancreatitis during pregnancy. Nat Rev Gastroenterol Hepatol 3, 53–57 (2006). https://doi.org/10.1038/ncpgasthep0390

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