Abstract
Introduction: The etiology of an acute necrotic pancreatitis is represented by gallstone disease, alcohol intake, abdominal trauma and drugs (in about %2 of cases). There are at least 100 drugs which can determine acute pancreatitis. Valproic acid-induced pancreatitis is reported as a complication of chronic therapy with this drug. Case Report: we report here the first case of acute pancreatitis in a 22-year-old comatose woman with valproic acid acute overdose in attempted suicide, a patient naive to valproate therapy. The patient presented 24 hours after ingestion of a massive dose of extended release valproate with profound coma, and features of acute necrotic pancreatitis, confirmed by contrast enhanced abdominal CT scan. She had favorable outcome with supportive and conservative treatment only. Conclusion: Emergency physicians should be aware of this unusual presentation of valproate toxicity, even in patients at first exposure to this drug.
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