Septic shock caused by postpartum acute pancreatitis, a case report and literature review
Dublin Core
Title
Septic shock caused by postpartum acute pancreatitis, a case report and literature review
Subject
Postpartum acute pancreatitis, Biliary obstruction, Gallstones, Septic shock
Description
Abstract
Introduction Postpartum acute pancreatitis (PAP) is a rare but potentially life-threatening condition that can occur
following childbirth. The incidence of PAP is estimated to be between 1 in 1,000 and 1 in 10,000 deliveries, with a sig-
nificant proportion of cases linked to biliary causes, particularly gallstones and biliary sludge. Prompt diagnosis
and comprehensive management are essential to prevent severe complications such as septic shock and peritonitis.
Case presentation We report the case of a 25-year-old white woman who presented with severe abdominal pain
and septic shock 18 days after a cesarean section. Initial management included aggressive fluid resuscitation, broad-
spectrum antibiotics, and pain control. Diagnostic imaging and laboratory tests confirmed the presence of biliary
obstruction due to gallstones and biliary sludge, leading to acute pancreatitis. An endoscopic retrograde cholangio-
pancreatography (ERCP) was performed to remove the biliary obstructions, followed by a laparoscopic cholecystec-
tomy to prevent recurrence.
Discussion PAP, while rare, poses significant risks and can lead to serious side effects such as septic shock. Early diag-
nosis by laboratory workup and imaging is essential. In this instance, gallstones and biliary sludge were found to be
the culprit, requiring cholecystectomy and ERCP. ERCP was effective in this patient, despite its controversy in septic
patients. The effective management of PAP requires a multidisciplinary approach involving obstetricians, gastroenter-
ologists, surgeons, and critical care specialists.
Conclusion PAP must be identified and treated as soon as possible. Bile obstruction is a common problem
that necessitates prompt imaging and, if necessary, endoscopic or surgical intervention. Delays can be fatal; timing
is crucial. To prevent deadly consequences, doctors must be extremely suspicious of postpartum patients presenting
with abdominal pain.
Keywords Postpartum acute pancreatitis, Biliary obstruction, Gallstones, Septic shock
Introduction Postpartum acute pancreatitis (PAP) is a rare but potentially life-threatening condition that can occur
following childbirth. The incidence of PAP is estimated to be between 1 in 1,000 and 1 in 10,000 deliveries, with a sig-
nificant proportion of cases linked to biliary causes, particularly gallstones and biliary sludge. Prompt diagnosis
and comprehensive management are essential to prevent severe complications such as septic shock and peritonitis.
Case presentation We report the case of a 25-year-old white woman who presented with severe abdominal pain
and septic shock 18 days after a cesarean section. Initial management included aggressive fluid resuscitation, broad-
spectrum antibiotics, and pain control. Diagnostic imaging and laboratory tests confirmed the presence of biliary
obstruction due to gallstones and biliary sludge, leading to acute pancreatitis. An endoscopic retrograde cholangio-
pancreatography (ERCP) was performed to remove the biliary obstructions, followed by a laparoscopic cholecystec-
tomy to prevent recurrence.
Discussion PAP, while rare, poses significant risks and can lead to serious side effects such as septic shock. Early diag-
nosis by laboratory workup and imaging is essential. In this instance, gallstones and biliary sludge were found to be
the culprit, requiring cholecystectomy and ERCP. ERCP was effective in this patient, despite its controversy in septic
patients. The effective management of PAP requires a multidisciplinary approach involving obstetricians, gastroenter-
ologists, surgeons, and critical care specialists.
Conclusion PAP must be identified and treated as soon as possible. Bile obstruction is a common problem
that necessitates prompt imaging and, if necessary, endoscopic or surgical intervention. Delays can be fatal; timing
is crucial. To prevent deadly consequences, doctors must be extremely suspicious of postpartum patients presenting
with abdominal pain.
Keywords Postpartum acute pancreatitis, Biliary obstruction, Gallstones, Septic shock
Creator
Changiz Delavari1 , Delaram J. Ghadimi2 , Maryam Taheri3 , Harsh Kumar4 , Pouya Ebrahimi3 ,
Amir Nasrollahizadeh3 and Sepide Javankiani1*
Amir Nasrollahizadeh3 and Sepide Javankiani1*
Source
https://doi.org/10.1186/s12245-025-00862-y
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Changiz Delavari1 , Delaram J. Ghadimi2 , Maryam Taheri3 , Harsh Kumar4 , Pouya Ebrahimi3 ,
Amir Nasrollahizadeh3 and Sepide Javankiani1*, “Septic shock caused by postpartum acute pancreatitis, a case report and literature review,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12732.