Severe Hypertriglyceridaemia-Induced Necrotising Pancreatitis Complicated by Multi-organ Failure: A Case Report

We report a case of a woman in her 30s presenting with severe epigastric pain and vomiting. Initial laboratory analysis was significantly delayed due to marked lipaemia. Subsequent investigations revealed an elevated serum amylase (2636 IU/L) and markedly raised fasting triglycerides (20.4 mmol/L). Imaging confirmed acute pancreatitis, which progressed to necrotising pancreatitis complicated by splenic vein thrombosis and infected intra-abdominal collections. Her clinical course was further complicated by acute respiratory distress syndrome and abdominal compartment syndrome, necessitating prolonged intensive care admission. Management included haemofiltration, insulin infusion for triglyceride reduction, anticoagulation, broad-spectrum antimicrobials, and image-guided drainage of infected collections. This case highlights the diagnostic and therapeutic challenges of hypertriglyceridaemia-induced pancreatitis and underscores the risk of significant complications and the importance of a multidisciplinary approach to such cases.