European Journal of Biomedical and Pharmaceutical Sciences

DELIRIUM TREMENS

Dr. Kimmyben Patel(M.B.B.S), Dr. Ankitkumar B. Patel(M.B.B.S),
Dr. Pokhraj Suthar (M.B.B.S, M.D.)*, Dr. Tarangkumar R. Bhavsar (M.B.B.S), Dr. Mashrutee Maharaul.

ABSTRACT

30-year-old male with family history of alcohol dependence in his father, presented to the emergency with acute pancreatitis and delirium. At age 28, he had had his first episode of acute pancreatitis and alcohol withdrawal delirium with convulsions, which was managed conservatively. Six days prior to presentation, recurrence of pancreatitis forced him to abstain from alcohol, and he developed DT and a withdrawal seizure. On examination, he was disorientated (time, place, and person), agitated, speaking irrelevantly, having visual hallucinations, and coarse tremors of hands. Serum lipase (662 units) and amylase (219 units) were raised. An ultrasound of abdomen showed a fatty liver with bulky pancreas and peripancreatic fluid. He was started on intramuscular thiamine and slow intravenous lorazepam, but did not improve and had to be intermittently physically restrained to prevent him from harming himself. Conservative management for pancreatitis was given. Over 24 hours, despite 48mg of intravenous lorazepam, he continued to have disorientation, tremors, agitation, irrelevant speech, visual hallucinations, and sleep disturbance. He was then transferred from the surgical ward to the de-addiction unit.

Keywords: alcohol dependence, peripancreatic fluid, Serum lipase (662 units).