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  • 1 SMS Medical College & Hospital Department of Gastroenterology Jaipur 302015 Rajasthan India
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The combination of heparin and insulin is a newer but not well-studied modality for the treatment of hypertriglyceridemia-induced acute pancreatitis. We report three patients of hypertriglyceridemia induced mild acute pancreatitis. Two patients had evidence of acute pancreatitis on abdominal CECT but their amylase and lipase levels were less than three times the upper limit of normal. Two patients were treated with heparin and insulin followed by fibrate, and the third was treated conservatively with fibrate only. The patients treated with insulin and heparin showed a rapid fall in triglyceride level (52%) on day one as compared to the patient treated conservatively (17.5%) with marked improvement in the pain score as assessed by the visual analogue scale. All the patients were maintained on fibrates to keep a level of triglycerides less than 200 mg/dL and were asymptomatic at 15, 27 and 40 months of follow-up.

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