Unmasking hidden culprits: The pivotal role of 4D CT in diagnosing parathyroid adenoma presenting as acute pancreatitis.

Primary hyperparathyroidism (PHPT) is an endocrine disorder that can rarely present with acute pancreatitis, a significant yet infrequent complication. We describe 2 patients-a 38-year-old male with a eutopic parathyroid adenoma and a 20-year-old male with an ectopic adenoma-both presenting with elevated parathyroid hormone levels, hypercalcemia, and recurrent acute pancreatitis. In each case, 4D Computed Tomography precisely localized the adenoma, enabling successful surgical resection and immediate normalization of biochemical abnormalities. These cases underscore the importance of considering PHPT in patients with hypercalcemia and pancreatitis and highlight the pivotal role of 4D CT for accurate adenoma localization and optimal surgical management.