Pranaya Gade, Samantha Walkow, Marina Bastawross, Ayesha Ain, Antonios Tsompanidis
Necrotizing pancreatitis (NP) is a severe and potentially life-threatening complication of acute pancreatitis (AP). This case report discusses NP in a 39-year-old male patient with severe hypertriglyceridemia (HTG), highlighting management and treatment with supportive measures, intravenous insulin, antibiotic use, and total parenteral nutrition (TPN). Despite episodes of hypoglycemia requiring discontinuation of insulin, his triglyceride (TG) levels steadily declined without the need for plasmapheresis or surgical intervention. However, the pancreatitis worsened, leading to circulatory shock due to the acute inflammatory effect of NP and acute renal failure. This case emphasizes the importance of timely diagnosis and multidisciplinary supportive care in the successful treatment of HTG-induced NP.