Rare cause of recurrent acute pancreatitis: a double whammy from the pancreas and duodenum

Clinical presentation A 16-year-old woman without past surgical or family history presented with intermittent abdominal pain accompanied by nausea and vomiting for 3 years. She was diagnosed with recurrent acute pancreatitis due to the elevation of amylase (three times the upper limit of normal) and evidence of interstitial pancreatitis on cross-sectional imaging. She was admitted to the hospital for further management. The laboratory examinations showed no remarkable abnormalities. The abdominal contrast-enhanced MRI showed pancreatic enlargement with dilated pancreatic duct (figure 1A). To further investigate the etiology of pancreatic duct dilatation and recurrent pancreatitis, endoscopic retrograde cholangiopancreatography was performed 2 days later and revealed duodenal stenosis (figure 1B) and a huge cystic-like submucosal lesion (diameter size about 4 cm) at the horizontal segment of the duodenum (figure 1C), which was not observed by previous abdominal imagings. Question What is the most...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot, Gut Editor ' s quiz: GI snapshot Source Type: research