Case of severe alcoholic hepatitis following acute pancreatitis

• Published in: Clinical journal of gastroenterology Vol. 17; no. 5; pp. 915 - 921
• Main Authors: Yokoyama, Takeru, Iwadare, Takanobu, Yamashita, Yuki, Momose, Akari, Ikeuchi, Hiroshi, Kondo, Shohei, Hashigami, Kenta, Iwaya, Mai, Kimura, Takefumi, Umemura, Takeji
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.10.2024
• Subjects: Abdominal Surgery; Acute Disease; Adult; Case Report; Colorectal Surgery; Female; Gastroenterology; Hepatitis, Alcoholic - complications; Hepatology; Hepatomegaly - diagnostic imaging; Hepatomegaly - etiology; Humans; Liver - diagnostic imaging; Liver - pathology; Medicine; Medicine & Public Health; Pancreatitis, Alcoholic - complications; Splenomegaly - diagnostic imaging; Splenomegaly - etiology; Surgical Oncology; Tomography, X-Ray Computed; Acute pancreatitis; Acute alcoholic pancreatitis; Alcoholic hepatitis; Severe alcoholic hepatitis
• ISSN: 1865-7257; 1865-7265; 1865-7265
• DOI: 10.1007/s12328-024-01988-x

This report describes the clinical course of a 41 year-old African woman who presented with an episode of acute alcoholic pancreatitis followed next by severe alcoholic hepatitis (SAH). Initially admitted for pancreatitis, the patient responded promptly to comprehensive treatment with strict abstinence from alcohol. However, remarkable elevations in white blood cell count to 44,000/µL and total bilirubin level to 12.4 mg/dL were observed 5–7 weeks later. Contrast-enhanced computed tomography revealed rapidly progressing hepatosplenomegaly. Histological analysis of a liver biopsy detected ballooned hepatocytes with Mallory–Denk bodies and significant neutrophilic infiltration in the hepatic parenchyma, which confirmed the diagnosis of SAH. The patient’s hepatosplenomegaly and overall condition improved with supportive care alone. The reported case reveals the unexpected fact that SAH can develop after alcoholic acute pancreatitis.