4 levels within two hours [26]. Consistent with earlier studies, Yeh et al. found that roughly two-thirds of cholesterol and triglycerides are removed after a single plasma exchange treatment, with an additional beneﬁt seen in the reduction of triglyceride levels after a second treatment [27]. In this study, 76.5% of hyperlipidemic pancreatitis patients treated with plasma exchange recovered completely. While Yeh et al. did not ﬁnd that the number of sessions of plasma exchange was linked to survival rates [27], subsequent papers have shown a use for long-term plasma exchange in controlling triglyceride levels [28]. Moreover, the American Society of Apheresis found moderate (category III) evidence support- ing plasmapheresis as a treatment of HTG pancreatitis [29]. This was based on a review of several published case reports and series, as well as a randomized controlled trial. Fortson et al. found abscess formation and mortality rates of 13% and 6%, respectively, in their review of HTG-induced acute pancreatitis cases managed supportively [11]. In contrast, Yeh et al. found rates of around 11% in their small case series [27]. This article also found that an increased risk of complications existed when fresh frozen plasma was used as the replacement ﬂuid, compared with human albumin solution. In early studies, overall mortality rates for pregnancy complicated by pancreatitis were initially quoted at up to 37% for both mother and child [30]. Foetal mortality rates quoted in the literature have improved in the last twenty years, as earlier studies reﬂected foetal deaths after preterm delivery which have reduced as a result of improved neonatal care [16]. This study found that 74% of patients suﬀering acute pancreatitis delivered full-term healthy infants, while a 10.5% foetal mortality rate was noted overall. A more recent study found a perinatal mortality rate of 3.6% [31]. It is, however, important to note that these publications do not distinguish between the various causes of acute pancreatitis during pregnancy. Tang et al. found that those mothers who developed pancreatitis in the ﬁrst trimester were more likely to experience foetal loss or preterm delivery [32]. A more recent review article found a maternal mortality rate of less than 1% for acute pancreatitis during pregnancy of all aetiologies [31]. Studies comparing the eﬀect of plasmapheresis ver- sus conservative management on morbidity and mortality in cases of HTG-induced acute pancreatitis found no statis- tical diﬀerence [33]. 4. Conclusion This paper details HTG of pregnancy as a rare cause of acute pancreatitis. It illustrates the diﬃculties associated with the diagnosis and prediction of severity in such cases, and the important alternative provided by CT predictive scoring. 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