Biliary sludge and acute pancreatitis during pregnancy.

BACKGROUND: A 34-year-old Hispanic woman at 34 weeks' gestation presented with upper-abdominal pain, nausea, and vomiting of 1 day's duration. She had no active medical problems and had undergone two prior Caesarean sections. Laboratory tests revealed elevated serum amylase and lipase levels. Ultrasonography demonstrated gallbladder sludge without gallstones, gallbladder wall thickening, or bile-duct dilatation. INVESTIGATIONS: Physical examination and laboratory tests of serum amylase, lipase, bilirubin, alkaline phosphatase, and transaminase levels. Abdominal ultrasonography. DIAGNOSIS: Biliary sludge and acute pancreatitis. MANAGEMENT: The patient was managed conservatively with narcotic pain control, intravenous hydration, nutritional support, and fetal monitoring. She subsequently underwent an uncomplicated Caesarean section. Laparoscopic cholecystectomy was performed 8 weeks postpartum.