{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:01:58Z","timestamp":1777863718135,"version":"3.51.4"},"reference-count":8,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Extensive burns are associated with numerous severe complications. While paralytic ileus is relatively common, the co-occurrence of acute pancreatitis (AP) is rare, clinically insidious, and highly fatal. Diagnosis is particularly challenging due to masking by critical illness and coexisting ileus. We present a 32-year-old male with 65% TBSA flame burns and inhalation injury, admitted in hypovolemic shock. Resuscitation followed Parkland protocol, and escharotomy was performed. On day 2, abdominal distension and reduced bowel sounds suggested paralytic ileus, managed with nasogastric decompression and parenteral nutrition. By day 5, epigastric pain developed. Serum amylase and lipase (peaking at 580.38\u2005U\/L) and urinary amylase were elevated. Abdominal CT and MRI confirmed AP. Treatment included strict nil-by-mouth, aggressive support, and somatostatin. Serum lipase normalized with clinical improvement, while urinary amylase remained elevated until day 13. The patient recovered fully after skin grafts and was discharged. This case underscores that AP can be a lethal burn complication often obscured by ileus. Serum lipase is more reliable than urinary amylase for diagnosis and monitoring, especially with concurrent kidney injury. Vigilance, timely imaging, and multimodal support are critical. Persistent urinary amylase may reflect renal dysfunction rather than ongoing pancreatitis.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1715967","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:30:10Z","timestamp":1777527010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Acute pancreatitis obscured by paralytic ileus in a patient with extensive burns"],"prefix":"10.3389","volume":"13","author":[{"given":"Hui","family":"Wang","sequence":"first","affiliation":[{"name":"First Ward of Department of Burn, Gansu Provincial Hospital","place":["Lanzhou, China"]},{"name":"Burns Clinical Medical Center, Gansu Provincial Hospital","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da","family":"Wang","sequence":"additional","affiliation":[{"name":"First Ward of Department of Burn, Gansu Provincial Hospital","place":["Lanzhou, China"]},{"name":"Burns Clinical Medical Center, Gansu Provincial Hospital","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"First Ward of Department of Burn, Gansu Provincial Hospital","place":["Lanzhou, China"]},{"name":"Burns Clinical Medical Center, Gansu Provincial Hospital","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s40779-022-00403-1","article-title":"Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China","volume":"9","author":"He","year":"2022","journal-title":"Mil Med Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.burns.2010.07.015","article-title":"The role of acute pancreatitis in pediatric burn patients","volume":"37","author":"Rivero","year":"2011","journal-title":"Burns"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/diagnostics13010001","article-title":"Abdominal compartment syndrome in acute pancreatitis: a narrative review","volume":"13","author":"Zarnescu","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1002\/ams2.181","article-title":"Acute pancreatitis and necrotizing colitis following extensive burn injury","volume":"3","author":"Osuka","year":"2016","journal-title":"Acute med Surg"},{"key":"B5","volume-title":"Serum Amylase in Chronic Kidney Disease: An Important Correlation","author":"Qureshi","year":"2023"},{"key":"B6","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1007\/s11605-019-04400-z","article-title":"Burn-Induced impairment of ileal muscle contractility is associated with increased extracellular matrix components","volume":"24","author":"Cummins","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1097\/BCR.0b013e318204b3be","article-title":"Early enteral nutrition in burns: compliance with guidelines and associated outcomes in a multicenter study","volume":"32","author":"Mosier","year":"2011","journal-title":"J Burn Care Res"},{"key":"B8","first-page":"257","article-title":"Ischemic intestinal complications in patients with burns","volume":"172","author":"Desai","year":"1991","journal-title":"Surg Gynecol Obste"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1715967\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:30:28Z","timestamp":1777527028000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1715967\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":8,"alternative-id":["10.3389\/fsurg.2026.1715967"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1715967","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"article-number":"1715967"}}