title: An atypical presentation of acute pancreatitis after simultaneous bilateral total knee replacement: A case report.
abstract: Acute pancreatitis is a known post-operative complication, commonly after abdominal surgery rather than total knee arthroplasty. When complications occur, post total knee arthroplasty, they tend to be cardiovascular and neurological events, rarely involving the gastrointestinal system. Therefore, when gastrointestinal complications occur, especially if they present with atypical symptoms, this tends to result in a delay in diagnosis. We present a case of acute pancreatitis post simultaneous bilateral total knee arthroplasty in a patient with risk factors like alcoholism and hypercholesterolaemia. Its atypical presentation of only persistent tachycardia, without abdominal pain, was misleading and the resultant delay in treatment dangerous. Therefore, it is important to consider acute pancreatitis as a differential diagnosis in a patient with persistent tachycardia post total knee arthroplasty, especially if he has risk factors for the condition.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Renyi Benjamin
authors.initials: RB
authors.lastname: Seah
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Shi-Lu
authors.initials: SL
authors.lastname: Chia
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Ken Lee
authors.initials: KL
authors.lastname: Puah
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Chee Cheng
authors.initials: CC
authors.lastname: Paul Chang
keywords: Acute pancreatitis; Bilateral; Simultaneous; Total knee arthroplasty