High Troponin-T in Acute Biliary Pancreatitis: Is it a Real Myocardial Injury?

Acute pancreatitis (AP) is characterized by abdominal pain and elevated levels of pancreatic enzymes in the serum. Pain is the hallmark of this condition, and as a presenting symptom, is localized in the epigastrium in at least 60% of patients having the mild or severe form of the disease. Thus, the differential diagnosis may be difficult in some cases due in part to the fact that the disease may mimic other diseases, and in particular, acute coronary syndrome. We present the case of a patient who presented to our facility with epigastric pain, normal electrocardiogram (ECG), elevated high-sensitive troponin-T and elevated lipase, and amylase. Laboratory investigations and ultrasonography confirmed AP, with further serial ECGs being within the normal limits and normal echocardiography. The patient underwent laparoscopic cholecystectomy and intraoperative cholangiogram. Postoperative diagnosis confirmed biliary pancreatitis with chronic cholecystitis.