Hypertriglyceridemic acute pancreatitis in a patient with Sheehan's syndrome.

BACKGROUND: There is no report on case of severe acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome. METHODS: A 32-year-old female patient was diagnosed as having acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome, and treated with diet and lipid-lowering agents in early stage. RESULTS: Abdominal pain and fever of the patient resolved within a few days. She was subjected to diet and oral lipid-lowering therapy on the 4th day after admission. The disease did not recur during the follow-up for more than one year. CONCLUSIONS: Estrogen replacement therapy should be prescribed for Sheehan's syndrome. The serum level of triglyceride should be monitored and treatment should be given to prevent severe acute pancreatitis. Lipid-lowering therapy in early stage is the key step towards a complete recovery.

Color Doppler ultrasonographic examination on the relationship between the gallbladder bed and major branch of the middle hepatic vein.

BACKGROUND: There is a controversy about the risk of injury to the branch of the middle hepatic vein during laparoscopic cholecystectomy. This study was conducted to further investigate the relationship between the gallbladder bed and the branch of the middle hepatic vein. METHODS: Color Doppler ultrasound was used to examine the anatomical relationship between the gallbladder bed and the branches of the middle hepatic vein in 143 healthy volunteers. RESULTS: Not all the middle hepatic vein extended close to the gallbladder bed, the branches and gallbladder beds in 23 subjects were not in the same plane during ultrasound scanning. In 21 of the 143 subjects the branch of the middle hepatic vein was completely adherent to the gallbladder bed with a diameter ranging from 1.2 mm to 3.6 mm. In 10 subjects the branches of the middle hepatic vein traversed approximately 1.0 mm from the gallbladder bed with a diameter ranging from 1.6 mm to 3.0 mm. CONCLUSIONS: In most subjects the branch of the middle hepatic vein and the gallbladder bed are well separated. Only patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy.