Hydrochlorothiazide as an Underrecognized Cause of Acute Pancreatitis: A Case Report and Literature Review.

Acute pancreatitis is a common inflammatory disorder of the pancreas. While commonly caused by gallstones, alcohol use, and idiopathic causes, drug-induced acute pancreatitis (DIAP) is an often overlooked etiology that demands careful medication review and clinical vigilance. This case report describes a 72-year-old male patient with a history of hypertension and coronary artery disease who presented with severe epigastric pain radiating to the back, elevated lipase levels, and imaging findings consistent with acute pancreatitis. After excluding common causes such as gallstones, alcohol use, and hypertriglyceridemia, hydrochlorothiazide (HCTZ) was identified as the likely trigger. Discontinuation of hydrochlorothiazide led to clinical improvement and resolution of laboratory abnormalities. This case highlights the importance of considering drug-induced acute pancreatitis, particularly in patients with comorbidities who present with unexplained acute pancreatitis due to their pharmacological therapy.