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Severe necrotizing pancreatitis immediately after non-abdominal surgery under general anesthesia with propofol

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Abstract

Postoperative pancreatitis is a relatively rare disease and is poorly recognized. Herein, we present a case of necrotizing pancreatitis that developed immediately after non-abdominal surgery under general anesthesia. In this report, 4 h after thyroidectomy under general anesthesia using propofol, the patient developed upper abdominal pain and was diagnosed with severe acute pancreatitis with extensive pancreatic necrosis. Immediately after the diagnosis, the patient received appropriate treatment, and acute pancreatitis was improved. Subsequently, the patient has the formation of non-infectious giant walled-off necrosis and remained in good condition without additional treatment for 1.5 years after pancreatitis onset. In this case report, our detailed causative search suggested that propofol administration could be the cause of this pancreatitis. Propofol-induced pancreatitis is extremely rare but develops often severely, resulting in fatality. In this case, the patient developed severe acute pancreatitis within a very short time after surgery but was able to survive by immediate intervention of treatment. We suggest that clinicians should consider acute pancreatitis as a life-threatening adverse event under general anesthesia with propofol and perform thorough postoperative management.

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Acknowledgements

This case report was partially supported by AMED under Grant Numbers JP21fk0210077, JP21fk0210047, and JP21fk0210058. We would also like to thank Editage (http://www.editage.com) for English language editing.

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Authors and Affiliations

  1. Faculty of Medical Sciences, Second Department of Internal Medicine, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Fukui, Yoshida-gun, 910-1193, Japan

    Yu Akazawa, Masahiro Ohtani, Shoichi Namikawa, Takuto Nosaka, Kazuto Takahashi, Tatsushi Naito, Kazuya Ofuji, Hidetaka Matsuda, Katsushi Hiramatsu & Yasunari Nakamoto

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  1. Yu Akazawa
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  2. Masahiro Ohtani
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  3. Shoichi Namikawa
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  4. Takuto Nosaka
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  5. Kazuto Takahashi
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  6. Tatsushi Naito
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  7. Kazuya Ofuji
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  8. Hidetaka Matsuda
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  9. Katsushi Hiramatsu
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  10. Yasunari Nakamoto
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Contributions

Y.A., M.O., and Y.S. contributed to the conception and design of the study. Y.A. collected and analyzed the data. Y.A. wrote the manuscript. All authors have reviewed and approved the final manuscript.

Corresponding author

Correspondence to Yasunari Nakamoto.

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Conflict of interest

Yu Akazawa, Masahiro Ohtani, Shoichi Namikawa, Takuto Nosaka, Kazuto Takahashi, Tatsushi Naito, Kazuya Ofuji, Hidetaka Matsuda, Katsushi Hiramatsu and Yasunari Nakamoto declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards defined in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from the patient for being included in the study.

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Akazawa, Y., Ohtani, M., Namikawa, S. et al. Severe necrotizing pancreatitis immediately after non-abdominal surgery under general anesthesia with propofol. Clin J Gastroenterol 14, 1798–1803 (2021). https://doi.org/10.1007/s12328-021-01504-5

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  • DOI: https://doi.org/10.1007/s12328-021-01504-5

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