Acute Biliary Pancreatitis in the First Trimester of Pregnancy Without Abdominal Pain, Associated With Vomiting: A Rare Atypical Clinical Case Report and a Mini-Review of the Literature.

Abstract

Acute pancreatitis is rare during pregnancy, with gallstone formation being the primary risk factor. This case report involves a 37-year-old pregnant woman, gravida 4, para 3, who presented to the Emergency Department of the General Hospital of Trikala at 13 weeks gestation, with vomiting for approximately 12 hours and no abdominal pain. A clinical examination by a surgical team, along with a history of cholelithiasis and supporting laboratory and ultrasound findings, led to the diagnosis of acute pancreatitis. The patient was carefully monitored and received immediate supportive treatment, including antibiotics. After a gradual improvement in clinical and laboratory findings, she was discharged on the sixth day of hospitalization, with the decision to postpone the cholecystectomy until after delivery, if possible. At 39 weeks of pregnancy, she delivered vaginally. One month later, she underwent a scheduled laparoscopic cholecystectomy. This case report describes a rare and atypical case of mild acute biliary pancreatitis in the first trimester of pregnancy, highlighting the management of the disease in pregnant women, which may vary depending on the severity of symptoms, potential complications, and gestational age.