Lets us see history of a patient:-

A 29 years old male presented with a 3 hours history of severe upper abdominal pain with profuse vomiting. The pain radiated into his back and wasn't relieved by any of the antacid therapies which he had tried at home. There was no previous history of abdominal pain. He was a non-smoker and consumed 1-2 units of alcohol on an infrequent basis.

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The reason behind the diagnosis was hypertriglyceridemia. It is a lipid disorder but people are not familiar with this term. They mostly know about cholesterol ( more accurately total cholesterol). Usually, in most of the lab, a  lipid profile includes following components: Total cholesterol, triglyceride, LDL(bad cholesterol), HDL(good cholesterol), VLDL and LDL: HDL ratio.  There might be abnormalities in a single isolated component or in a combined manner. Our patient was having a high level of triglyceride named as hypertriglyceridemia.
<center>![Multiple eruptive xanthoma.jpg](https://res.cloudinary.com/hpiynhbhq/image/upload/v1518852158/qnjnopte5mixbi5up8fc.jpg)
_The image is taken from one of my books. it is showing multiple eruptive lesions found in hypertryceridemia_</center>
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The actual diagnosis was **Acute pancreatitis**. The pancreas is an abdominal organ which is related to one of the well-known diseases named Diabetes Mellitus(DM). Insulin comes from the Beta cells of Islets of Langerhans; the endocrine portion of the gland, and the deficiency of insulin leads to DM. The exocrine portion secrets various enzymes which are involved in the digestion process of different foods in the intestine.  Hypertriglyceridemia is one of the causes of acute pancreatitis though it is not the commonest one. Here is the list of causes of acute pancreatitis:
* Alcohol abuse (commonest causes in developed countries)
* Gallstones 
* Trauma to the abdomen 
* ERCP; an investigation where a narrow tube is inserted in biliary tree
* Some virus infection notably coxsackie and mumps
* **Hypertriglyceridemia**
* Raised blood calcium level
Some drugs: Thiazides, steroids, azathioprine

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#### <center>How a patient may die from acute pancreatitis?</center>

Acute pancreatitis >> haemorrhage or bleeding in abdomen, and/or profuse vomiting (our patient) >> leads to hypovolemia (less blood volume or body fluid) >> acute renal failure >> death (if untreated)
 #### <center>Or</center>
Acute pancreatitis >> leakage of trypsin which damage surfactant; a compound in lungs which is necessary for normal breathing >> acute respiratory distress syndrome (ARDS)>> respiratory failure >> death

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