Acute pancreatitis due to severe hypertriglyceridemia: a case report

Kim Y.H.; González R.B.; Ortiz J.C.L.; Guevara C.A.A.; Mendoza A.A.H. · Horizonte Medico (2026) · DOI: 10.24265/horizmed.2026.v26n2.08

Resumen

Acute pancreatitis is an inflammatory disease of the pancreas and the most frequent gastrointestinal cause of hospitalization. Although most cases are related to cholelithiasis or alcohol consumption, hypertriglyceridemia is a less common but clinically relevant cause, particularly when triglyceride levels exceed 1,000 mg/dL. We report the case of a 37-year-old man with metabolic and lifestyle risk factors who presented with severe abdominal pain. Blood tests revealed marked lipemia, and his triglyceride level reached 4,603 mg/dL. Imaging studies confirmed pancreatitis without necrosis, and the patient improved after treatment with fenofibrate and atorvastatin. Hypertriglyceridemia is the third most frequent cause of acute pancreatitis and tends to affect young patients with obesity, high-fat diets, and other metabolic factors. The pathophysiology remains incompletely understood and is considered multifactorial, involving genetic, metabolic, and environmental mechanisms. Management is based on standard supportive care for pancreatitis and rapid reduction of triglyceride levels using fibrates, statins, omega-3 fatty acids, insulin with heparin, or, in some cases, plasmapheresis. Comparative studies suggest that pancreatitis due to hypertriglyceridemia is often more severe than biliary or alcoholic pancreatitis, with a higher risk of systemic complications. This case highlights the importance of early recognition of acute pancreatitis due to hypertriglyceridemia. Clinical suspicion, imaging confirmation, and rapid control of triglyceride levels, together with supportive care, allow a favorable clinical course and reduce complications, recurrences, and morbidity and mortality in patients with predisposing metabolic factors.