TY - JOUR AU - Ana Tonceanu AU - R. Palade AU - R. Grigorescu AU - T. Trotea AU - Florentina Mușat PY - 2018/12/19 Y2 - 2024/03/28 TI - THERAPEUTIC PLASMAPHERESIS IN PRIMARY PRESENTATION OF DIABETES MELLITUS WITH DIABETIC KETOACIDOSIS, HYPERTRIGLYCERIDEMIA AND ACUTE PANCREATITIS JF - Journal of Surgical Sciences JA - JSS VL - 5 IS - 3 SE - Articles DO - 10.33695/jss.v5i3.231 UR - https://journalofsurgicalsciences.com/index.php/jss/article/view/231 AB - We present a case of severe hypertriglyceridemia-induced acute pancreatitis associated withdiabetic ketoacidosis, managed in the intensive care unit. The patient was a 39-year-old woman, with amedical history of Graves-Basedow disease, essential arterial hypertension and morbid obesity(body mass index=31). Firstly, we aggressively corrected hypovolemia and hemodynamicimbalances (administrating fluids and systemic anticoagulant) and then we focused on the infectionprevention and control of intra-abodminal pressure, for the latter outcome. We decided to start the firstsession of plasma exchange. The patient responded well to the treatment applied. Plasma-exchangewas very efficient, reducing TG levels by 60% after the first treatment and achieving a decrease of77.6% at the third plasmapheresis session. This case was safely and effectively managed withplasmapheresis (three sessions), antibiotics, multimodal analgesia (intravenous and thoracicepidural catheter), early jejunal nutrition and forced mobilization. The patient's evolution wassignificantly favorable, with a reduction of the peripancreatic necrosis on computer scan, at day 28and she was discharged with a normal value of TG and without pain or any clinical signs. ER -