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Unusual presentation of additional widespread disease/injuryCASE REPORTPoorly controlled sort two diabetes complicated by an episode of severe hypertriglyceridaemiainduced pancreatitisNathalie Denecker, Katelijn DecochezDepartment of EndocrinologyDiabetes, UZ Brussel, Brussels, Belgium Correspondence to Dr Nathalie Denecker, [email protected] A 23-year-old woman having a history of sort 2 diabetes and non-compliance presented to the emergency division with abdominal epigastric pain and nausea.1810068-31-5 Chemscene Laboratory examination revealed a mild ketoacidosis while an abdominal CT scan performed the following day demonstrated a serious acute pancreatitis on the body and tail (Balthazar grade E) despite typical amylase serum levels on admission.tert-Butyl (3-iodopropyl)carbamate Data Sheet The presence of a lactescent serum was the clue to an very higher triglyceride level (10 000 mg/dl) causing the pancreatitis.PMID:24381199 The hypertriglyceridaemia itself was attributed mainly towards the diabetic ketoacidosis. There was no family members history of hypertriglyceridaemia. The triad consisting of diabetic ketoacidosis, hypertriglyceridaemia and acute pancreatitis is an unusual presentation of poorly controlled diabetes which can occur in form 1 also as sort two diabetic adults and young children. Treatment with intravenous insulin and hydration successfully resolved the ketoacidosis and hypertriglyceridaemia and reversed the episode of acute pancreatitis.BACKGROUNDAlthough it truly is recognised that diabetic ketoacidosis may present with abdominal discomfort, it remains critical to exclude an underlying acute pancreatitis which may well be masked due to ambiguous presentation. Furthermore, it has been demonstrated that in case of hyperlipidaemic serum normoamylasaemia can occur in much more than half in the patients presenting with acute pancreatitis as a result of serious hypertriglyceridaemia. With this unusual case we emphasise the should carry out an abdominal CT scan in case of persistent abdominal discomfort in ketoacidosis, specially in case of a hyperlipidaemic serum, even when inflammatory parameters are absent and clinical symptoms are only mild. Also this uncommon diagnosis really should not be missed in youngsters hence avoiding unnecessary surgical interventions for presumed acute abdominal conditions.she had been admi.