SHM Converge Scientific Abstract ePoster Gallery-Acute Pancreatitis in a Patient Infected With Covid 19

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This case report describes an 18-year-old vaccinated man with no significant medical history who developed acute pancreatitis associated with COVID-19 infection. He presented with two days of sharp epigastric pain radiating to the back, vomiting, and fever after known COVID exposure. Although he had no respiratory symptoms, testing confirmed SARS-CoV-2 infection.<br /><br />Initial evaluation showed mild leukocytosis and elevated lipase. CT imaging demonstrated acute pancreatitis with marked hypodensity in the pancreatic tail, raising concern for necrosis or abscess. Common causes of pancreatitis were excluded: there was no gallstone disease, alcohol use, hypertriglyceridemia, hypercalcemia, autoimmune pancreatitis, EBV, or bacterial infection. Because COVID-19 was the only identifiable cause, the team concluded that the pancreatitis was likely COVID-induced.<br /><br />He was treated conservatively with aggressive IV fluids, bowel rest, pain control, and antibiotics due to concern for necrosis. Despite initial worsening on repeat CT, his symptoms gradually improved, and he was discharged on a low-fat diet. About one month later, he was readmitted with recurrent epigastric pain. MRI showed pancreatic tail pseudocyst formation without necrosis, and he recovered with conservative management.<br /><br />The discussion highlights that COVID-19 can cause extra-pulmonary complications, including acute pancreatitis, likely through ACE-2 receptor-mediated viral entry into pancreatic tissue, inflammatory injury, and endothelial damage causing microischemia. The authors emphasize that although gallstones and alcohol remain the most common causes of pancreatitis, infectious causes account for a meaningful minority of cases. Clinicians should consider COVID-19 in patients presenting with unexplained pancreatitis, even in the absence of respiratory symptoms and even among vaccinated individuals.

Asset Subtitle

Titilope Obayomi

Meta Tag

Author List Ayfer Ekiz, Titilope Obayomi, Yuliya Levkiavska

Category Clinical Vignettes

Concept Acute Pancreatitis

Concept COVID-19

Concept Supportive Care

Concept Gallstone

Concept Hypertriglyceridemia

Distinguished Non-Finalist

Presenter Organization Garnet Health Medical Center

Presenting Author Titilope Obayomi

Track Adult

Keywords

COVID-19

acute pancreatitis

SARS-CoV-2

pancreatic tail

pseudocyst

vaccinated patient

epigastric pain

lipase elevation

ACE-2 receptor

extra-pulmonary complication

Acute Pancreatitis

COVID-19

Supportive Care

Gallstone

Hypertriglyceridemia