Acute gallstone pancreatitis is a rare occurrence in pregnancy and the postpartum period. However, gallstone pancreatitis should be considered in a differential diagnosis for right upper quadrant (RUQ) pain in this population, as the risk of biliary stasis and gallstone formation increases in pregnancy due to high levels of circulating estrogen causing increased cholesterol formation and delayed gallbladder emptying. Although gallstones are the most common cause of acute pancreatitis in pregnancy, alcohol use and hypertriglyceridemia may also be considered. In this case report, we present a G1P0 female pregnant with monochorionic diamniotic twins who developed postpartum acute gallstone pancreatitis status post Cesarean section.
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