HYPERTRIGLYCERIDEMIA AND ACUTE-PANCREATIT IS

Data of 26 patients suffering from severe pancreatitis, who were treat ed at the anesthesiologic intensive care unit during the years 1991 an d 1992, were evaluated with respect to etiologic factors, especially h ypertriglyceridemia, stage of the disease and clinical outcome. Hypert riglyceridemia was found in 13 cases (11 men, 2 women, mean age 42 +/- 9 years) with values between 330 mg/dl and 4000 mg/dl. Lipid electrop horesis revealed a pattern typical for type TV hyperlipidemia. Insulin dependent diabetes was present in 4 patients and 5 reported about an unusual high alcohol intake preceding pancreatitis. Beside surgical ap proaches, including drainage and lavage, and basic intensive care trea tment plasmapheresis was performed in 8 patients with hypertriglycerid emia. 5 patients with pancreatitis and hypertriglyceridemia died out o f multiorganic failure, and so the mortality rate was 38%. The group o f patients with pancreatitis caused by cholelithiasis or chronic alcoh ol consumption showed a mortality rate of 46%. The poor outcome of pan creatitis associated with hypertriglyceridemia demonstrates the import ance of the treatment of hypertriglyceridemia in order to prevent the development of pancreatitis. The determination of plasma triglyceride values should belong to the routine diagnostic procedures in acute pan creatitis.