Failure of heparin associated to insulin in treatment of a hypertriglyceridemia-induced acute pancreatitis

was significant for sensibility in the epigastric region without palpable spleen or any mass. Capillary dextrose was 4.47g/l and urines ketones were positives. Intensive management was started immediately. Physiologic saline serum 0.9% was administered by two peripheral venous catheters (16G). A tracheal tube after a crush induction by Etomidat and succinylcholine allowed invasive ventilation under 60% of oxygen to reach 98% of saturation. Sedation was realized with fentanyl only at first. Then, femoral venous catheter allows adrenalin administration at progressively dose to 0.5μg/kg/min for obtaining stabilized hemodynamic status. Her first labs were significant for blood lipase of 609 UI/L. White blood cells count was 17100/mm3 and serum triglyceride level was elevated at 11g/l. Serum anion gap was normal. Chest X-ray was normal. Abdominal CT scan showed a necrosis of the pancreatic parenchyma and peri pancreatic tissues without fluid collection.