PANCREATITIS IN PREGNANCY: CASE MANAGMENT
Abstract
The purpose of the review is to summarise the current data on chronic and acute pancreatitis with the goal to improve the diagnostics and treatment of women during pregnancy, which complicates differential diagnosis of hepatopancreatobiliary system pathology. The features of the incidence, etiology, pathogenesis and evaluation of the severity of the clinical manifestations of acute pancreatitis in pregnant women are given. It is emphasis that the most frequent its reason is the gallstones following by the biliary pancreatitis. The experience of use in pregnant patients imaging methods - endoscopic ultrasound, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography, as well as treatments that include endoscopic sphincterotomy, stone extraction from the common bile duct and laparoscopic cholecystectomy. The recommendations are based on expert opinions and are not supported by randomized controlled trials. Nevertheless more active clinical management allows to diagnose and treat effectively pancreatitis, including biliary etiology, which contributes to a sharp decline in maternal and perinatal mortality.
About the Authors
I. O. Marinkin
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
T. M. Sokolova
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
T. V. Kiseleva
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
V. M. Kuleshov
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
K. Yu. Makarov
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
A. V. Yakimova
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
S. V. Aidagulova
FSBEF HE NSMU HMR - Federal State Budget Educational Foundation of the High Education «Novosibirsk State Medical University» of the Health Ministry of Russia
Russian Federation
Russian Federation
References
1. Айламазян Э. К., Кулаков В. И., Радзинский В. Е. Акушерство: Национальное руководство. Москва: ГЭОТАР-Медиа; 2013. 1200 с.
2. Маев И. В., Бурков С. Г., Кучерявый Ю. А., Овлашенко Е. И. Течение, диагностика и лечение острого панкреатита в период беременности. Проблемы женского здоровья. 2007. Т. 2, № 4. С. 38-45.
3. Pitchumoni C. S., Yegneswaran B. Acute pancreatitis in pregnancy. World J. Gastroenterol. 2009. Vol. 15, № 45. P. 5641-5646. doi: 10.3748/wjg.15.5641.
4. Jeon H. R., Kim S. Y., Cho Y. J., Chon S. J. Hypertriglyceridemia-induced acute pancreatitis in pregnancy causing maternal death. Obstet Gynecol Sci. 2016. Vol. 59, № 2. P. 148-151. doi: 10.5468/ogs.2016.59.2.148.
5. Ramin K. D., Ramsey P. S. Disease of the gallbladder and pancreas in pregnancy. Obstet. Gynecol. Clin. North. Am. 2001. Vol. 28, № 3. P. 571-580. http://www.ncbi.nlm.nih.gov/pubmed/11512501.
6. Eddy J. J., Gideonsen M. D., Song J. Y. et al. Pancreatitis in pregnancy. Obstet. Gynecol. 2008. Vol. 112, № 5. P. 1075-1081. doi:10.1097/AOG.0b013e 318185a032.
7. Cain M. A., Ellis J., Vengrove M. A. et al. Gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy. Obstet. Gynecol. Surv. 2015. Vol. 70, № 9. P. 577-583. doi: 10.1097/OGX.0000000000000216.
8. Ивашкин В. Т., Маев И. В., Охлобыстин А. В. и др. Рекомендации российской гастроэнтерологической ассоциации по диагностике и лечению хронического панкреатита. Рос. Журн. Гастроэнтерол. Гепатол. Колопроктол. 2014. Т. 24, № 4. С. 70-97.
9. Hoffmeister A., Mayerle J., Beglinger C. et al. English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis. Z. Gastroenterol. 2015. Vol. 53, № 12. P. 1447-1495. doi: 10.1055/s-0041-107379.
10. Banks P. A., Bollen T. L., Dervenis C. et al. (Acute Pancreatitis Classification Working Group). Classification of acute pancreatitis - 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013. Vol. 62. P. 102-111. doi:10.1136/ gutjnl-2012-302779.
11. Schepers N. J., Bakker O. J., Besselink M. G. et al. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial. Trials. 2016. Vol. 17. doi: 10.1186/s13063-015-1132-0.
12. Dufour M. C., Adamson M. D. The epidemiology of alcohol-induced pancreatitis. Pancreas. 2003. Vol. 27. P. 286-290.
13. UK Working Party on Acute Pancreatitis. UK guidelines for the management of acute pancreatitis. Gut. 2005. Vol. 54 (Suppl. 3): iii1-9.
14. Saldivar-Rodríguez D., Treviño-Montemayor O. R., Guzmán-López A. et al. Acute pancreatitis in pregnancy. Ginecol. Obstet. Mex. 2016. Vol. 84, № 2. P. 79-83. http://www.ncbi.nlm.nih.gov/pubmed/27290834.
15. Bank S., Singh P., Pooran N., Stark B. Evaluation of factors that have reduced mortality from acute pancreatitis over the past 20 years. J. Clin. Gastroenterol. 2002. Vol. 35. P. 50-60.
16. van Geenen E. J., Smits M. M., Schreuder T. C. et al. Smoking is related to pancreatic fibrosis in humans. Am. J. Gastroenterol. 2011. Vol. 106. P. 1161-1166.
17. Samal S., Gupta S., Begum J., Ghose S. Misdiagnosis of Abdominal Pain in Pregnancy: Acute Pancreatitis. J. Clin. Diagn. Res. 2015. Vol. 9, № 1. P QD05-QD06. doi: 10.7860/JCDR/2015/9003.5389.
18. Jacob J. J., John M., Thomas N. et al. Does hyperparathyroidism cause pancreatitis? A South Indian experience and a review of published work. ANZ J. Surg. 2006. Vol. 76. P. 740-744.
19. Rebours V., Boutron-Ruault M. C., Schnee M. et al. The natural history of hereditary pancreatitis: a national series. Gut. 2009. Vol. 58. P. 97-103.
20. Kamisawa T., Egawa N., Nakajima H. et al. Clinical difficulties in the differentiation of autoimmune pancreatitis and pancreatic carcinoma. Am. J. Gastroenterol. 2003. Vol. 98. P. 2694-2699.
21. Bakker O. J., van Santvoort H. C., Hagenaars J. C. et al. Timing of cholecystectomy after mild biliary pancreatitis. Br. J. Surg. 2011. Vol. 98. P. 1446-1454.
22. Okoro N., Patel A., Goldstein M. et al. Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis. Gastrointest. Endosc. 2008. Vol. 68. P. 69-74.
23. Pandey M., Shukla V. K. Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer. Eur. J. Cancer Prev. 2003. Vol. 12. P. 269-272.
24. See A. T., Irvine L. M. Modern management of acute biliary pancreatitis in pregnancy. J. Obstet. Gynaecol. 2010. Vol. 30, № 4. P. 410-411. doi: 10.3109/ 01443611003725472
25. Ko C. W., Beresford S. A., Schulte S. J. et al. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology. 2005. Vol. 41. P. 359-365.
26. Gupta N., Ahmed S., Shaffer. L. et al. Severe hypertriglyceridemia induced pancreatitis in pregnancy. Case Rep Obstet Gynecol. 2014. 2014: 485493. doi: 10.1155/2014/485493.
27. Johnson A., Cluskey B., Hooshvar N. et al. Significantly elevated serum lipase in pregnancy with nausea and vomiting: acute pancreatitis or hyperemesis gravidarum? Case Rep Obstet Gynecol. 2015; 2015:359239. doi: 10.1155/2015/359239.
28. Хворостухина Н. Ф., Салов И. А., Новичков Д. А. Острый панкреатит беременных. Клиническая медицина. 2015. Т. 93, № 2. С. 61-66. http://www.ncbi.nlm.nih.gov/pubmed/26117921.
29. Еремина Е. Ю. Панкреатит у беременных. Гастроэнтерология. 2012. Т. 3 (58). С. 23-28.
30. Headley A. J., Blechman A. N. Diagnosis of macroamylasemia in a pregnant patient. J. Natl. Med. Assoc. 2008. Vol. 100, № 11. P. 1359-1361. doi:10.1016/S0027-9684(15)31516-9.
31. Ducarme G., Maire F., Chatel P. et al. Acute pancreatitis during pregnancy: a review. J Perinatol. 2014. Vol. 34, № 2. P. 87-94. doi: 10.1038/jp.2013.161.
32. Abdullah B., Pillai T. K., Cheen L. H., Ryan R. J. Severe acute pancreatitis in pregnancy. Case Rep Obstet Gynecol. 2015. 2015:239068. doi: 10.1155/2015/239068.
33. Lee Y. T., Chan F. K., Leung W. K. et al. Comparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study. Gastrointest Endosc. 2008. Vol. 67. P. 660-668.
34. Moon E. K., Wang W., Newman J. S., Bayona-Molano M. P. Challenges in interventional radiology: the pregnant patient. Semin Intervent Radiol. 2013. Vol. 30, № 4. P. 394-402. doi: 10.1055/s-0033-1359734.
35. Janssen J., Halboos A., Greiner L. EUS accurately predicts the need for therapeutic ERCP in patients with a low probability of biliary obstruction. Gastrointest Endosc. 2008. Vol. 68. P. 470-476.
36. Lee J. J., Lee S. K., Kim S. H. et al. Efficacy and safety of pancreatobiliary endoscopic procedures during pregnancy. Gut Liver. 2015. Vol. 9, № 5. P. 672-678. doi: 10.5009/gnl14217.
37. Banks P. A., Freeman M. L. Practice guidelines in acute pancreatitis. Am. J. Gastroenterol. 2006. Vol. 101. P. 2379-2400.
38. Sand J., Nordback I. Probiotics in severe acute pancreatitis. Lancet. 2008. Vol. 371. P. 634-635.
39. Dhupar R., Smaldone G. M., Hamad G. G. Is there a benefit to delaying cholecystectomy for symptomatic gallbladder disease during pregnancy? Surg. Endosc. 2010. Vol. 24, № 1. P. 108-112. doi: 10.1007/s00464- 009-0544-x.
40. Bani Hani M. N., Bani-Hani K. E., Rashdan A. et al. Safety of endoscopic retrograde cholangiopancreatography during pregnancy. ANZ J. Surg. 2009. Vol. 79. P. 23-26.
41. Tang S. J., Rodriguez-Frias E., Singh S. et al. Acute pancreatitis during pregnancy. Clin. Gastroenterol. Hepatol. 2010. Vol. 8, № 1. P. 85-90. doi: 10.1016/j.cgh.2009.08.035.
Review
For citations:
Marinkin I.O., Sokolova T.M., Kiseleva T.V., Kuleshov V.M., Makarov K.Yu., Yakimova A.V., Aidagulova S.V. PANCREATITIS IN PREGNANCY: CASE MANAGMENT. Experimental and Clinical Gastroenterology. 2016;(9):91-97. (In Russ.)
Views:
264
Email this article 