Treatment of hyperlipidemic pancreatitis in pregnancy with total parenteral nutrition.

A 29-yr-old pregnant woman presented in her third trimester with severe pancreatitis, hyperlipidemia, and small-for-dates fetus. Studies suggested that her pancreatitis was caused by profound hypertriglyceridemia, which was the result of an underlying lipoprotein disorder exacerbated by pregnancy. Throughout the first 7 wk of hospitalization, attempts to refeed the patient with solid food and various elemental diets resulted in the induction of hypertriglyceridemia and relapses of pancreatitis. Concern for the nutritional status of the mother and the possibility of further growth retardation of the fetus prompted the use of total parenteral nutrition for the last 2 wk of gestation. This treatment was well tolerated by the mother, promptly reversed maternal weight loss, caused a rapid resolution of her pancreatitis, and did not induce further hypertriglyceridemia. This report documents that total parenteral nutrition may be safely and effectively used in the management of hyperlipidemic pancreatitis in pregnancy.