Primary hyperparathyroidism presenting as acute pancreatitis

We present the case of a 26-year-old male who presented with abdominal pain and malaise for 7 days. Biochemical evidence confirmed acute pancreatitis (AP) with hypercalcemia and raised parathyroid hormone levels. Imaging by contrast-enhanced computed tomography of the abdomen demonstrated acute edematous pancreatitis and a left renal calculus. Sestamibi scintigraphy suggested a right inferior parathyroid adenoma, confirming the diagnosis. The patient was initially managed with intravenous fluids, analgesics, and calcium-lowering therapy using intravenous zoledronic acid and calcitonin. After stabilizing the patient, definitive surgical management with parathyroidectomy was planned, which was performed successfully, and the patient was discharged. This case highlights the significance of assessing serum calcium levels in patients with idiopathic AP, specifically younger individuals. Early recognition and definitive surgical treatment of primary hyperparathyroidism hold importance for the prevention of recurrent pancreatitis and related complications, ensuring good outcomes. The following core competencies are addressed in this article: Medical Knowledge, Patient Care and Procedural Skills, Diagnostic Evaluation and Clinical Decision-Making, and Interdisciplinary Collaboration.