Necrotizing pancreatitis during pregnancy: a rare cause and review of the literature.

Acute pancreatitis is an uncommon cause of abdominal pain during pregnancy, and rarely progresses to the necrotizing from of the disease in this clinical setting. Hyperlipidemia is an infrequent cause of acute pancreatitis. Whereas only 100 cases of hyperlipidemia-induced necrotizing pancreatitis have been reported in the literature to date, all of the cases were mild in severity and responsive to conservative medical management. Herein we present a case of life-threatening necrotizing pancreatitis, which developed in a hyperlipidemic pregnant woman and required multiple peripartum pancreatic necrosectomies. Additionally, we review the evaluation of pregnant patients with abdominal pain, the pathophysiology of hyperlipidemia-induced necrotizing pancreatitis, and the operative care of this challenging group of patients, revisiting an innovative technique for management of the retroperitoneum.