Hypertriglyceridemia induced acute necrotizing pancreatitis in an adolescent with diabetic ketoacidosis

Acute pancreatitis (AP), a potentially life-threatening inflammatory disease, can manifest as severe necrotizing pancreatitis (NP) with high mortality. Hypertriglyceridemia (HTG) is an emerging cause of AP, often linked with metabolic conditions like diabetic ketoacidosis (DKA). This case report highlights a 12-year-old female presenting with DKA complicated by HTG-induced NP. The patient had no prior history of diabetes or dyslipidemia, but her presentation was marked by severe abdominal pain, hyperglycemia, and elevated pancreatic enzymes. Management included aggressive hydration, intravenous insulin, and antibiotic therapy for pancreatic necrosis. Despite initial stabilization, complications such as paralytic ileus and pleural effusion extended the hospital stay. This case underscores the need for heightened clinical suspicion of concurrent AP in pediatric DKA, particularly in obese patients with elevated triglycerides (TG), as delayed diagnosis can result in significant morbidity. Early intervention and multidisciplinary management are critical to improving outcomes.