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Case of acute pancreatitis during Covid-19 Volume 31, issue 5-6, Septembre-Décembre 2022

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Authors
1 Faculté de médecine, université d’Antananarivo, centre hospitalier de Soavinandriana, Antananarivo, Madagascar
2 Faculté de médecine, université d’Antananarivo, centre hospitalier universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
3 Faculté de médecine, université d’Andrainjato Fianarantsoa, centre hospitalier universitaire Tambohobe, Fianarantsoa, Madagascar
* Tirés à part : Johary Andriamamonjisoa

Several clinical manifestations of Covid-19 are possible, the literature describes digestive symptoms of this disease. Sars-Cov-2 binds to ACE2 receptors in the body, its expression is slightly higher in the pancreas than in the lungs. This expression plays an important role in the clinical manifestations and severity. The involvement of the pancreas in Covid-19 could range from simple inflammation to severe pancreatitis. A 55-year-old woman was admitted to hospital with a confirmed case of severe Covid-19 with a pulse oxygen saturation of 89% on room air. She presented with severe transfixing abdominal pain in the epigastrium on about day 11 of symptom progression. Lipasemia was increased by six times normal. Abdominopelvic CT scan showed extensive fatty infiltration of the pancreas with loss of lobulation in the corporocaudal area. She had three of the major criteria for the diagnosis of Atlanta acute pancreatitis. The diagnosis of Baltazar C acute pancreatitis was made, which progressed favourably with digestive rest and analgesics. All the usual causes of acute pancreatitis were ruled out in our patient. It is important to consider that Sars-Cov-2 infection could be one of the causes of acute pancreatitis. Thus, the mechanism remains to be proven with further studies on animal models or biopsy samples.