Implications of a blood sample with an extremely high lipid content in the emergency department: a case report

Abstract

Non-measurable blood test results are difficult to diagnose in emergency departments (EDs), especially since most emergency blood tests are performed in these settings. In this case, we present a 33-year-old male patient who consulted to the ED with worsening left flank pain and vomiting that started 6 hours before presentation. A comprehensive metabolic panel was not reported, as the test sample was high in lipids. On non-enhanced abdomen/pelvic computed tomography (CT), fluid collection around the pancreatic tail, without necrotic changes of parenchymal tissue suggested the possibility of acute pancreatitis. Blood investigations revealed a marked increase in triglyceride levels (8001 mg/dL). The patient was then admitted to the intensive care unit for severe hypertriglyceridemia-induced acute pancreatitis (HTG-induced AP), and later discharged home after treatment for seven days with insulin therapy and routine medication for hyperlipidemia. We present a case in which the laboratory comments of ???not available for analysis??? with regard to a blood sample have diagnostic implications.