Crohn's Disease Presenting As Chronic Pancreatitis With Biliary Tract Obstruction

Evans, Jonathan; George, Donald E.; Barwick, Kenneth W.; Lafer, Dennis J.

doi:10.1097/00005176-199605000-00008

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…Pancreatitis in patients with CD and substantial duodenal involvement is probably caused by reflux of duodenal contents into the pancreatic duct (87), stenosis of the ampulla of Vater (88), and in one report a persimmon bezoar lodging in the duodenum was described (89). In addition, partial obstruction of the intramural duodenal portion of the common bile duct can be the cause of pancreatitis (64,90). One report demonstrated a patient with an inflammatory mass in the head of the pancreas.…”

Section: Diagnosismentioning

confidence: 99%

Proximal Crohn's Disease: Review of the Clinicopathologic Features and Therapy

Hogezand

Witte

Veenendaal

et al. 2001

Inflammatory Bowel Diseases

102

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Crohn's disease in the proximal region of the digestive tract is uncommon. Better diagnostically procedures and more careful histologic examination has led to a higher detection of proximal Crohn's disease. The diagnosis is based on symptoms, endoscopy with serial sections, or double contrast radiography. The most common histologic finding for this diagnosis are granulomas in the mucosa in Helicobacter pylori-negative patients, but the granulomas are not always frequently detected. Endoscopic lesions in the proximal regions look like the lesions that could be found in the distal regions. Notching in the duodenal folds could be a strong indication for Crohn's desease. Radiological lesions are not always characteristic, but should be used in combination with endoscopy. Stenosis is an important complication, but fistula formation and pseudodiverticular formation is possible. There is no uniform medical therapy, but the regular anti-inflammatory management for Crohn's disease is most often used. Sometimes surgery is needed.

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Section: Diagnosismentioning

confidence: 99%

Proximal Crohn's Disease: Review of the Clinicopathologic Features and Therapy

Hogezand

Witte

Veenendaal

et al. 2001

Inflammatory Bowel Diseases

102

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“…Chronic pancreatitis (CP) is a rare condition in the pediatric population and is mainly associated with genetic alterations [ 4 ]. Only four cases of CP coexisting with IBD in children after recurrent episodes of AP have been well documented [ 42 , 43 , 44 ]. Two of these patients had the mutation in the CFTR (cystic fibrosis transmembrane conductance regulator) gene, which was possibly involved in CP development [ 8 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

Pancreatic Disorders in Children with Inflammatory Bowel Disease

et al. 2021

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Background and Objectives: Inflammatory bowel disease (IBD) is a chronic condition and mainly affects the intestines, however, the involvement of the other organs of the gastrointestinal tract (upper part, pancreas, and liver) have been observed. The coexistence of IBD with pancreatic pathology is rare, however, it has been diagnosed more frequently during recent years in the pediatric population. This article reviews the current literature on the most common pancreatic diseases associated with IBD in the pediatric population and their relationship with IBD activity and treatment. Materials and Methods: We performed a systematic review of data from published studies on pancreatic disorders, also reported as extraintestinal manifestations (EIMs), among children with IBD. We searched PubMed and Web of Science to identify eligible studies published prior to 25 April 2020. Results: Forty-four papers were chosen for analysis after a detailed inspection, which aimed to keep only the research studies (case control studies and cohort studies) or case reports on children and only those which were written in English. The manifestations of IBD-associated pancreatic disorders range from asymptomatic increase in pancreatic enzymes activity to severe disease such as acute pancreatitis. Acute pancreatitis (AP) induced by drugs, mainly thiopurine, seems to be the most- often-reported pancreatic disease associated with IBD in children. AP associated with other than drug etiologies, and chronic pancreatitis (CP), are rarely observed in the course of pediatric IBD. The pancreatic involvement can be strictly related to the activity of IBD and can also precede the diagnosis of IBD in some pediatric patients. The course of AP is mild in most cases and may occasionally lead to the development of CP, mainly in cases with a genetic predisposition. Conclusions: The involvement of the pancreas in the course of IBD may be considered as an EIM or a separate co-morbid disease, but it can also be a side effect of IBD therapy, therefore a differential diagnosis should always be performed. As the number of IBD incidences with concomitant pancreatic diseases is constantly increasing in the pediatric population, it is important to include pancreatic enzymes level measurement in the workup of IBD.

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“…Duodenal localization in CD may be related to increased risk of pancreatitis or pancreatic compression interrupter due to flow obstruction, reflux of duodenal contents into the pancreatic ducts caused by an inflamed sphincter or for the presence of duodenal-pancreatic duct fistulae. [24] Other forms of secondary pancreatitis may also be associated with primary sclerosing cholangitis (PSC). PSC is a chronic inflammatory disease of the intrahepatic and extrahepatic system characterized by fibrosis which causes cholestasis, biliary cirrhosis and liver failure, with occasional involvement of the pancreatic ducts (0%-77%) and development of pancreatitis.…”

Section: Biliopancreatic Disorders and Pancreatitismentioning

confidence: 99%