Background: Severe hypertriglyceridemia (triglyceride >1000 mg/dl) occurs at a rate of 0.4% and is associated with a range of medical complications including severe pancreatitis and its complications like acute kidney injury . Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis especially in levels above 1000 mg/dl. It has been suggested that insulin [...]

Case Presentation: A 39 year-old female with a history of hypertriglyceridemia (HTG), IDDM2, and obesity presented to an outside hospital with severe epigastric abdominal pain and was diagnosed with recurrent hypertriglyceridemia-induced pancreatitis (HTGP). Intravenous insulin was started and she was transferred to our hospital for management. On arrival, she was tachycardic and tachypneic with a [...]

Case Presentation: A 31-year-old-female presented to the hospital with a one-day history of severe left lower quadrant abdominal pain that was gradual in onset, associated with nausea and emesis. She also reported epigastric and left flank pain. She experienced a similar episode two months prior, which lasted several days. She denied hematuria, vaginal discharge, or [...]

Case Presentation: Our case involves a 45-year-old male with a history of alcohol abuse, who presented with acute epigastric pain and bilious emesis. On exam, he had severe epigastric tenderness with guarding and normoactive bowel sounds. When obtaining labs, his blood was grossly turbid. Labs were significant for elevated lipase (1,534 IU/L), normal TSH (1.23 [...]

Case Presentation: A 45-year-old woman with type 2 diabetes mellitus (DM) and dyslipidemia presented with a 2-day history of nausea, vomiting, and epigastric pain. Two years earlier, she had an episode of pancreatitis secondary to hypertriglyceridemia (HTG; 1120 mg/dL), which was treated with gemfibrozil and atorvastatin. Her family history was significant for hyperlipidemia and type [...]

Case Presentation: A 38-year-old female with a past medical history of recurrent pancreatitis, heart failure with recovered ejection fraction, type 2 diabetes mellitus, and hyperlipidemia presented with acute-onset abdominal pain, nausea, and vomiting. Her history was notable for no alcohol use, a prior cholecystectomy, and an episode of pancreatitis with an unclear cause several months [...]

Case Presentation: A 49-year-old male with past medical history of alcohol use disorder, hypertension, and necrotizing pancreatitis presented with severe epigastric pain for one day. The pain was sharp, non-radiating, worsened by eating, and associated with nausea and diarrhea. He drinks a fifth of hard liquor daily. Pertinent labs showed bicarbonate 8 with an anion [...]

Case Presentation: A 38-year-old Asian American male presented with severe non-radiating upper abdominal pain for the previous 18 hours. The pain was exacerbated with deep breathing and movement. He had no significant past medical, surgical, or family history. He drank two alcoholic drinks per week and did not smoke. The only medication he reported taking [...]

Case Presentation: 29-year-old man with no significant medical history presented with 1 day of severe epigastric pain and multiple episodes of emesis and nausea. He denied any alcohol use.​Vitals: ​Remarkable for a heart rate of 110. ​Notable Labs & Imaging:​Bicarbonate 16 mmol/L with an anion gap of 23 ​Glucose 117 mg/dL​Lactate 2.9 mmol/L​Lipase 531 U/L​Normal [...]

Case Presentation: 44-year-old male with past medical history of diabetes mellites, hypertension, pancreatitis and hypertriglyceridemia presented to the ED with acute abdominal pain and vomiting. Physical examination was unremarkable other than epigastric tenderness and elevated BMI of 33. Chemistry revealed glucose: 259 mg/dL, bicarbonate: 20 mmol/L, anion gap 19, lipase 1170 U/L, WBC count 15.6K/cc, [...]