Post-whipple pancreatitis! | Figure 1

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Post-whipple pancreatitis!

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A 47 y o obese male (BMI 37.2) with history of DM 2 on insulin pump presented with severe abdominal pain, nausea and vomiting ongoing for 2 days. He reported pain was sudden,constant and worse with food. Pain didn't improve with oral pain medicines at home including oxycodone he takes because of chronic back pain. Patient had Whipple procedure done for a tumor of pancreatic head (found to be benign in nature). Patient continued to have recurrent abdominal pain after the procedure. He did not have any fever and his bowel movements remained normal. He did not have any other known medical problems or surgeries. No known drug allergies. Home medication included insulin pump and oral pain medications. He gave a remote history of alcohol use. No other illicit drug use. He works at a Landscape company. On physical exam, vitals remained stable. There was reproducible epigastric and periumbilical tenderness with no guarding or rigidity with normal bowel sounds. Labs were unremarkable including lipase. CT abdomen pelvis revealed acute pancreatitis of remaining part of pancreas. He was treated conservatively with IV fluids, NPO, and pain meds. His pain persisted for 3 days with treatment and thus MRCP was done. It did not reveal any Whipple related complications. Patient gradually improved and was discharged home. Patient was instructed to supplement meals with pancreatic enzymes.

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