Acute pancreatitis revealing ulcerative colitis—A case report

Abstract

The association of acute pancreatitis with ulcerative colitis [UC] has been described in the literature. It is usually induced by drugs, but sometimes it may be idiopathic. This association remains rare. We report the case of a patient who was treated in our department. Medical observation: Mr. KA, a 60-year-old man, was admitted in our unit for management of acute epigastric. The clinical examination at the admission was normal. After eliminating a cardiac or surgical cause, the diagnosis of acute pancreatitis was made on the basis of the presence of a serum lipase up to 5 times the normal level and pain intensity. An abdominal scanner tomography was performed for the assessment of the pancreatitis. It has shown a pancreatitis stage C associated with a thick rectosigmoidien that was discovered incidentally. Symptomatology was enriched 10 days after by the occurrence of rectal bleeding. A lower endoscopy was performed after the improvement of the pancreatitis and had shown an ulcerative colitis on pancolitis which was confirmed by biopsy. In order to search other causes of this pancreatitis, other tests were made [a biliary IRM, endoscopic ultrasonography, autoimmune tests] and the results were negative. We concluded an idiopathic pancreatitis. The ulcerative colitis was classified as moderate and the patient was put on oral corticosteroids with degression. The evolution was marked by a clinical and biological improvement of pancreatitis and colitis. Conclusion: The association of idiopathic pancreatitis with ulcerative colitis is rare. The case of our patient is the first case reported in our series with 400 cases of ulcerative colitis diagnosed in our service.

Share and Cite:

Bousfiha, N. , Iliass Charif, I. , el Abkari, M. , Ibrahimi, A. and Mellouki, I. (2014) Acute pancreatitis revealing ulcerative colitis—A case report. Open Journal of Gastroenterology, 4, 16-18. doi: 10.4236/ojgas.2014.41003.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Watanabe, T. (2008) Parotitis and acute pancreatitis in a patient with ulcerative colitis. European Journal of Pediatrics, 167, 945. http://dx.doi.org/10.1007/s00431-007-0593-x
[2] Son, C.N., Lee, H.L., Joo, Y.W., Lee, O.Y., Han, D.S., et al. (2008) A case of acute pancreatitis induced by multiple drugs in a patient with ulcerative colitis. The Korean Journal of Gastroenterology, 52, 192-195.
[3] Halabi, I.M. (2009) Ulcerative colitis presenting as acute pancreatitis in a 6-year-old patient. Gastroenterology & Hepatology, 5, 429-430.
[4] Bermejo, F., Lopez-Sanroman, A., Taxonera, C., Gisbert, J.P., Perez-Calle, J.L., et al. (2008) Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine-induced pancreatitis. Alimentary Pharmacology & Therapeutics, 28, 623-628. http://dx.doi.org/10.1111/j.1365-2036.2008.03746.x
[5] Kim, K.H., Kim, T.N. and Jang, B.I. (2007) A case of acute pancreatitis caused by 5-aminosalicylic acid suppositories in a patient with ulcerative colitis. The Korean Journal of Gastroenterology, 50, 379-383. (in Korean)
[6] Saez, J., Martinez, J., Garcia, C., Grino, P. and Perez-Mateo, M. (2000) Idiopathic pancreatitis associated with ulcerative colitis. The American Journal of Gastroenterology, 95, 3004-3005.
[7] Ball, W.P., Baggenstooss, A.H., Barjon, J.A., et al. (1950) Pancreatic associated with chronic ulcerative colitis. Archives of Pathology, 345-348.
[8] Paul, A.C., Oommen, S.P., Angami, S. and Moses, P.D. (2000) Acute pancreatitis in a child with idiopathic ulcerative colitis on long-term 5-aminosalicylic acid therapy. Indian Journal of Gastroenterology, 19, 195-196.
[9] Khanna, S. and Kumar, A. (2003) Acute pancreatitis due to hydrocortisone in a patient with ulcerative colitis. Journal of Gastroenterology and Hepatology, 18, 1110-1111. http://dx.doi.org/10.1046/j.1440-1746.2003.03129.x
[10] Nedin, D. and Aleksandrova, A. (2004) Pancreatitis accompanying inflammatory bowel diseases, and our observations. Khirurgiia (Sofia), 60, 12-17. (in Bulgarian)
[11] Barthet, M., Hstier, P., Bernard, J.-P., et al. (1999) Chronic pancreatitis and inflammatory Bowel disease: True or coincidental association. The American Journal of Gastroenterology, 94, 2141-2148. http://dx.doi.org/10.1111/j.1572-0241.1999.01287.x
[12] Seyrig, J.A., Jian, R., Modigliani, R., Golfain, D., Florent, C., et al. (1985) Idiopathic pancreatitis associated with inflammatory bowel disease. Digestive Diseases and Sciences, 30, 1121-1126. http://dx.doi.org/10.1007/BF01314044
[13] Heikius, B., Niemela, S., et al. (1999) Elevated pancreatie enzymzs in IBD are associated with extensive disease. American Journal of Gastroenterology, 94, 1062-1069. http://dx.doi.org/10.1111/j.1572-0241.1999.01015.x
[14] Borkje, B., Vetvik, K., Odegaard, S., Schrumpf, E., Larssen, T.B. and Kolmannskog, F. (1985) Chronic pancreatitis in patients with sclerosing cholangitis and ulcerative colitis. Scandinavian Journal of Gastroenterology, 20, 539-542. http://dx.doi.org/10.3109/00365528509089693
[15] Stocker, W., Otte, M., Ulrich, S., Normann, D., Finkbeiner, H., Stokker, K., Jantschek, G. and Scriba, P.C. (1987) Autoimmunity to pancreatic juice in Crohn’s disease. Results of an autoantibody screening in patients with chronic inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 139, 41-52. http://dx.doi.org/10.3109/00365528709089774
[16] Okano, A., Takakuwa, H., et al. (2003) Idiopathic pancreatitis may be associated with ulcerative colitis. Internal Medicine, 42, 125-126. http://dx.doi.org/10.2169/internalmedicine.42.125

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.