Abstract
BACKGROUND: Acute lung injury and acute respiratory distress syndrome are potentially fatal complications of severe acute pancreatitis. In some cases, respiratory failure in acute pancreatitis is associated with negative radiographic findings. Hypertriglyceridemia is a known precipitant of acute pancreatitis; however, whether the severity of the hypertriglyceridemia can accurately predict the severity of the hypoxemia in acute pancreatitis remains unclear. CASE PRESENTATION: A male with morbid obesity and untreated sleep apnea presented with hypoxemia in the setting of severe hypertriglyceridemia, but with negative chest imaging. The severity of the patient's respiratory dysfunction coincided with elevations in his serum triglycerides. CONCLUSIONS: This case demonstrates the complex relationship between hypertriglyceridemia, inflammation, and pulmonary dysfunction.