Acute pancreatitis has occasionally been associated with Crohn's disease, but whether a causal association exists remains unclear.
Dr Picha Moolsintong and colleagues determined the frequency of etiologies in a consecutive series of patients with Crohn's disease with acute pancreatitis.
A centralized diagnostic index was used to identify all patients with Crohn's disease with acute pancreatitis.
| Duodenal Crohn's involvement occurred in 12%|
|Inflammatory Bowel Diseases|
The patients were evaluated at Mayo Clinic Rochester between 1976 and 2001.
Both diagnoses were made or confirmed at the investigators' institution.
The investigators abstracted records for demographics, presenting symptoms, diagnostic tests, risk factors of pancreatitis, treatment, and follow-up.
The investigative team identified 48 patients with Crohn's disease with pancreatitis.
The median age at diagnosis of acute pancreatitis was 47 years.
A further 96% met biochemical criteria for acute pancreatitis.
The team found that the most sensitive radiographic tests were abdominal computed tomography in 70% and abdominal ultrasound in 46%.
The etiology of pancreatitis was considered to be gallstones in 21%, significant alcohol intake in 15%, and use of purine analogs in 13%.
Duodenal Crohn's involvement in 12%, and postendoscopic retrograde cholangiopancreatography complications in 10% was part of the etiology of pancreatitis.
In addition, the team observed that postoperative complications occurred in 12%, use of other medications in 4% and idiopathic in 8%.
The median length of hospitalization was 7 days.
The team noted that 21% of patients had recurrence of acute pancreatitis.
The investigators found that 6% of patients were subsequently diagnosed with pancreatic cancer.
Dr Moolsintong's team concluded, “A definite etiology could be identified in most patients with Crohn's disease with acute pancreatitis.”
“Gallstones and alcohol accounted for more than a third of cases, whereas Crohn's disease, either because of duodenal involvement or medications used for its treatment, accounted for more than one quarter of the cases.”
“A small proportion of patients remained idiopathic.”