Case report: A fatal case of severe pancreatitis associated with rhabdomyolysis

Saw Kian Cheah, Mohamed Izzad Bin Isahak, Wan Rahiza Wan Mat, Shereen Suet Ping Tang, Rufinah Teo, Aliza Mohamad Yusof, Raha Abdul Rahman

Research output: Contribution to journalArticle

Abstract

Background: Rhabdomyolysis is an uncommon presentation associated with severe acute pancreatitis (SAP). Patients usually present late and asymptomatic, thus it carries poorer clinical outcome and higher mortality rate. Case report: We report a case of SAP in a 42- year-old man who presented with persistent epigastric pain, elevated serum amylase, and characteristics of acute pancreatitis on the contrast- enhanced computed tomography of the abdomen. Investigations revealed persistent hyperkalemia and severely elevated creatinine kinase in the presence of acute kidney injury, which led to the uncommon possibility of diagnosing severe rhabdomyolysis. He suffered com-. plications of intra-abdominal hypertension, feeding intolerance, severe ARDS and multiorgan failure. He succumbed to death after a month despite aggressive intensive care therapies and support. Discussion: The actual pathophysiology of rhabdomyolysis in SAP is complex. It is postulated that acute inflammation of pancreas causes ATP-dependent proton pump dysfunctions leading to skeletal muscle cells injury and therefore, rhabdomyolysis. Conclusion: Coexistence of rhabdomyolysis with SAP have higher risk for fatality, therefore, its presence allows early triage, early aggressive resuscitation and intensive care management.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalCritical Care and Shock
Volume22
Issue number5
Publication statusPublished - Oct 2019

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Rhabdomyolysis
Pancreatitis
Critical Care
Intra-Abdominal Hypertension
Proton Pumps
Hyperkalemia
Triage
Amylases
Acute Kidney Injury
Resuscitation
Abdomen
Muscle Cells
Pancreas
Creatinine
Skeletal Muscle
Phosphotransferases
Adenosine Triphosphate
Tomography
Inflammation
Pain

Keywords

  • Acute kidney injury
  • ATP-dependent proton pump
  • Hyperkalemia
  • Rhabdomyolysis
  • Severe acute pancreatitis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Cheah, S. K., Isahak, M. I. B., Wan Mat, W. R., Tang, S. S. P., Teo, R., Yusof, A. M., & Rahman, R. A. (2019). Case report: A fatal case of severe pancreatitis associated with rhabdomyolysis. Critical Care and Shock, 22(5), 275-280.

Case report : A fatal case of severe pancreatitis associated with rhabdomyolysis. / Cheah, Saw Kian; Isahak, Mohamed Izzad Bin; Wan Mat, Wan Rahiza; Tang, Shereen Suet Ping; Teo, Rufinah; Yusof, Aliza Mohamad; Rahman, Raha Abdul.

In: Critical Care and Shock, Vol. 22, No. 5, 10.2019, p. 275-280.

Research output: Contribution to journalArticle

Cheah, SK, Isahak, MIB, Wan Mat, WR, Tang, SSP, Teo, R, Yusof, AM & Rahman, RA 2019, 'Case report: A fatal case of severe pancreatitis associated with rhabdomyolysis', Critical Care and Shock, vol. 22, no. 5, pp. 275-280.
Cheah SK, Isahak MIB, Wan Mat WR, Tang SSP, Teo R, Yusof AM et al. Case report: A fatal case of severe pancreatitis associated with rhabdomyolysis. Critical Care and Shock. 2019 Oct;22(5):275-280.
Cheah, Saw Kian ; Isahak, Mohamed Izzad Bin ; Wan Mat, Wan Rahiza ; Tang, Shereen Suet Ping ; Teo, Rufinah ; Yusof, Aliza Mohamad ; Rahman, Raha Abdul. / Case report : A fatal case of severe pancreatitis associated with rhabdomyolysis. In: Critical Care and Shock. 2019 ; Vol. 22, No. 5. pp. 275-280.
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