Acute idiopathic pancreatitis in patients with inflammatory bowel disease: A retrospective case-series description

Abstract

SUMMARY
Background/aims: To describe five patients who developed
acute idiopathic pancreatitis either before (two patients)
or after (three patients) the establishment of diagnosis of
the underlying inflammatory bowel disease (IBD). Results:
These patients represent an incidence for patient-years of
0.14% (3 cases with acute pancreatitis after the establishment
of diagnosis of IBD per 2183 person-years, 95% CI
0.02-0.30%) and a frequency of 1.53 (5 patients with acute
pancreatitis among 327 patients with IBD, 95% CI 0.20-
2.86%). Extensive work-up aiming to identify an etiological
factor, known to be involved in the pathogenesis of acute
pancreatitis was negative. Four of these patients had
Crohn’s disease and one had ulcerative colitis. Three
patients developed acute pancreatitis during a flare-up of
the underlying IBD, while in two the appearance of acute
pancreatitis preceded the clinical manifestations of IBD.
The course of pancreatitis was favourable in the majority
of cases. In one patient the administration of Infliximab
resulted in prompt improvement of clinical and laboratory
parameters. During the follow-up period, ranging from 14
months to 7 years, an exacerbation of pancreatitis was noted
in one patient. Conclusion: This retrospective case-series
suggests that acute idiopathic pancreatitis accompanies
IBD, especially of Crohn’s disease, either before or following
the establishment of diagnosis of IBD. Large epidemiological
studies are needed in order to further clarify the
relationship between acute idiopathic pancreatitis and IBD. Key words: Pancreatitis, idiopathic pancreatitis, inflammatory
bowel disease, Crohn’s disease, ulcerative colitis