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An enigmatic triad of acute pancreatitis, diabetic ketoacidosis and hypertriglyceridaemia: who is the culprit?
  1. Umasankar Mathuram Thiyagarajan1,
  2. Amirthavarshini Ponnuswamy2 and
  3. Alex Chung3
  1. 1 Department of Hepatobiliary-Pancreatic Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, UK
  2. 2 Department of Accident &Emergency, Eastbourne District General Hospital, Eastbourne, UK
  3. 3 General Surgery, St Georges Hospital NHS Trust, London, UK
  1. Correspondence to Mr Umasankar Mathuram Thiyagarajan, umasurgeon{at}


Acute pancreatitis(AP) is one of the common causes of acute abdomen and known to be associated with high morbidity and mortality in severe cases. Though most common causes of AP are cholelithiasis and alcoholism, it has also been reported in association with diabetic ketoacidosis (DKA). Triad of AP, hypertriglyceridaemia (HTG) and DKA is rare co-association and here the causal factor of AP is still not fully established. We report a case of AP in a DKA patient with recent diagnosis of hyperlipidaemia and diabetes. Usually AP has been associated with severe HTG; interestingly, our patient showed only moderate raise in triglycerides but still suffered AP during DKA. Hence, it raises question about the real culprit in this enigmatic triad.

  • gastrointestinal system
  • diabetes
  • lipid disorders
  • metabolic disorders
  • pancreatitis

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  • Contributors UMT: conception and design, planning, conduct, reporting and wrote the case report. AP: literature search and design, acquisition of data analysis and interpretation of data. AC: supervised planning, reporting, conception and design and finalised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.