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Hypertriglyceridaemic Pancreatitis — RACP Adult Medicine MCQ

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ModerateGastroenterologyHypertriglyceridaemic PancreatitisRACP Adult Medicine

A 45-year-old man presents with acute epigastric pain radiating to the back. Lipase is 1500 U/L. He has hypertriglyceridaemia (triglycerides 28 mmol/L). He is not a drinker and has no gallstones. What is the most likely cause of his pancreatitis?

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Correct answer: D — Hypertriglyceridaemia-induced pancreatitis

Triglyceride levels >11 mmol/L can cause acute pancreatitis. This is the third most common cause after gallstones and alcohol. Mechanisms include toxic effects of free fatty acids on pancreatic acinar cells. Acute management includes insulin infusion (activates lipoprotein lipase to reduce triglycerides) and plasmapheresis for severe cases (TG >22 mmol/L). Long-term: fibrates, diet, and control of secondary causes.

Reference: GESA – 2024 – Acute Pancreatitis; AGA 2024