ÖZET
Akut pankreatit, en yaygın olarak safra taşının neden olduğu pankreasın iltihaplı bir durumudur. Hamilelik sırasında akut pankreatit olgularının yaklaşık %70’i safra taşı veya çamura ikincildir. Akut pankreatit, 1,500-4,500 gebelikte bir bildirilen insidansı ile nadir bir komplikasyondur. Safra taşları safra kanalı tıkanıklığına ve pankreas hiperstimülasyonuna neden olur. Bu süreçler, hidrostatik basıncı, tripsin geri akışını ve pankreas içindeki sindirim enzimlerinin aktivasyonunu artırarak pankreasın kendi kendine sindirilmesine ve ardından lokal iltihaplanmaya neden olur. Hamilelik sırasında, hamileliğin steroid hormonları safra kesesi hareketliliğini ve safra içeriğini etkiler. Progesteron safra kesesi düz kas gevşemesine neden olur ve östrojenler safra kolesterol seviyesini yükselterek safra stazını artırır. Klinik semptomlar arasında sağ üst karın bölgesinde ve/veya epigastrik bölgede ağrı, sağ flank, skapula ve omuza yayılabilen ağrı, iştahsızlık, bulantı, kusma, dispepsi, düşük dereceli ateş ve sinüs taşikardisi, hiperventilasyon ve nefesin aseton kokusu yer alır. Gebelikte akut pankreatit tanısı, laboratuvar incelemeleri ve görüntüleme yöntemleri ile doğrulanır. Gebelik sırasında akut biliyer pankreatitin yönetimi büyük ölçüde benzerdir.
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