Acute pancreatitis in patients with Crohn's disease: Clinical features and outcomes

Picha Moolsintong, Edward Vincent Loftus, Jr, Suresh T Chari, Laurence J. Egan, William J. Tremaine, William J. Sandborn

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: Acute pancreatitis has occasionally been associated with Crohn's disease (CD), but whether a causal association exists remains unclear. We sought to determine the frequency of etiologies in a consecutive series of patients with CD with acute pancreatitis. Methods: A centralized diagnostic index was used to identify all patients with CD with acute pancreatitis that were evaluated at Mayo Clinic Rochester between 1976 and 2001. Both diagnoses were made or confirmed at our institution. Records were abstracted for demographics, presenting symptoms, diagnostic tests, risk factors of pancreatitis, treatment, and follow-up. Results: Forty-eight patients with CD with pancreatitis were identified. The median age at diagnosis of acute pancreatitis was 47 years (range, 31-91 yr). Forty-six (96%) met biochemical criteria for acute pancreatitis. The most sensitive radiographic tests were abdominal computed tomography (70%) and abdominal ultrasound (46%). The etiology of pancreatitis was considered to be gallstones (21%), significant alcohol intake (15%), use of purine analogs (13%), duodenal Crohn's involvement (12%), postendoscopic retrograde cholangiopancreatography complications (10%), postoperative complications (12%), use of other medications (4%) and idiopathic (8%). The median length of hospitalization was 7 days (range, 0-40 d). Ten patients (21%) had recurrence of acute pancreatitis. Three patients (6%) were subsequently diagnosed with pancreatic cancer. Conclusions: A definite etiology could be identified in most patients with CD with acute pancreatitis. Gallstones and alcohol accounted for more than one third of cases, whereas CD, 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.

Original languageEnglish (US)
Pages (from-to)1080-1084
Number of pages5
JournalInflammatory Bowel Diseases
Volume11
Issue number12
DOIs
StatePublished - Dec 2005

Fingerprint

Crohn Disease
Pancreatitis
Gallstones
Alcohols
Pancreatic Neoplasms
Routine Diagnostic Tests
Hospitalization
Tomography
Demography
Recurrence
Therapeutics

Keywords

  • 5-aminosalicylate toxicity
  • Acute pancreatitis
  • Azathioprine toxicity
  • Crohn's disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Acute pancreatitis in patients with Crohn's disease : Clinical features and outcomes. / Moolsintong, Picha; Loftus, Jr, Edward Vincent; Chari, Suresh T; Egan, Laurence J.; Tremaine, William J.; Sandborn, William J.

In: Inflammatory Bowel Diseases, Vol. 11, No. 12, 12.2005, p. 1080-1084.

Research output: Contribution to journalArticle

Moolsintong, Picha ; Loftus, Jr, Edward Vincent ; Chari, Suresh T ; Egan, Laurence J. ; Tremaine, William J. ; Sandborn, William J. / Acute pancreatitis in patients with Crohn's disease : Clinical features and outcomes. In: Inflammatory Bowel Diseases. 2005 ; Vol. 11, No. 12. pp. 1080-1084.
@article{a21418fa6d9747ed8649e1835c913a46,
title = "Acute pancreatitis in patients with Crohn's disease: Clinical features and outcomes",
abstract = "Background: Acute pancreatitis has occasionally been associated with Crohn's disease (CD), but whether a causal association exists remains unclear. We sought to determine the frequency of etiologies in a consecutive series of patients with CD with acute pancreatitis. Methods: A centralized diagnostic index was used to identify all patients with CD with acute pancreatitis that were evaluated at Mayo Clinic Rochester between 1976 and 2001. Both diagnoses were made or confirmed at our institution. Records were abstracted for demographics, presenting symptoms, diagnostic tests, risk factors of pancreatitis, treatment, and follow-up. Results: Forty-eight patients with CD with pancreatitis were identified. The median age at diagnosis of acute pancreatitis was 47 years (range, 31-91 yr). Forty-six (96{\%}) met biochemical criteria for acute pancreatitis. The most sensitive radiographic tests were abdominal computed tomography (70{\%}) and abdominal ultrasound (46{\%}). The etiology of pancreatitis was considered to be gallstones (21{\%}), significant alcohol intake (15{\%}), use of purine analogs (13{\%}), duodenal Crohn's involvement (12{\%}), postendoscopic retrograde cholangiopancreatography complications (10{\%}), postoperative complications (12{\%}), use of other medications (4{\%}) and idiopathic (8{\%}). The median length of hospitalization was 7 days (range, 0-40 d). Ten patients (21{\%}) had recurrence of acute pancreatitis. Three patients (6{\%}) were subsequently diagnosed with pancreatic cancer. Conclusions: A definite etiology could be identified in most patients with CD with acute pancreatitis. Gallstones and alcohol accounted for more than one third of cases, whereas CD, 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.",
keywords = "5-aminosalicylate toxicity, Acute pancreatitis, Azathioprine toxicity, Crohn's disease",
author = "Picha Moolsintong and {Loftus, Jr}, {Edward Vincent} and Chari, {Suresh T} and Egan, {Laurence J.} and Tremaine, {William J.} and Sandborn, {William J.}",
year = "2005",
month = "12",
doi = "10.1097/01.MIB.0000186485.30623.ad",
language = "English (US)",
volume = "11",
pages = "1080--1084",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "12",

}

TY - JOUR

T1 - Acute pancreatitis in patients with Crohn's disease

T2 - Clinical features and outcomes

AU - Moolsintong, Picha

AU - Loftus, Jr, Edward Vincent

AU - Chari, Suresh T

AU - Egan, Laurence J.

AU - Tremaine, William J.

AU - Sandborn, William J.

PY - 2005/12

Y1 - 2005/12

N2 - Background: Acute pancreatitis has occasionally been associated with Crohn's disease (CD), but whether a causal association exists remains unclear. We sought to determine the frequency of etiologies in a consecutive series of patients with CD with acute pancreatitis. Methods: A centralized diagnostic index was used to identify all patients with CD with acute pancreatitis that were evaluated at Mayo Clinic Rochester between 1976 and 2001. Both diagnoses were made or confirmed at our institution. Records were abstracted for demographics, presenting symptoms, diagnostic tests, risk factors of pancreatitis, treatment, and follow-up. Results: Forty-eight patients with CD with pancreatitis were identified. The median age at diagnosis of acute pancreatitis was 47 years (range, 31-91 yr). Forty-six (96%) met biochemical criteria for acute pancreatitis. The most sensitive radiographic tests were abdominal computed tomography (70%) and abdominal ultrasound (46%). The etiology of pancreatitis was considered to be gallstones (21%), significant alcohol intake (15%), use of purine analogs (13%), duodenal Crohn's involvement (12%), postendoscopic retrograde cholangiopancreatography complications (10%), postoperative complications (12%), use of other medications (4%) and idiopathic (8%). The median length of hospitalization was 7 days (range, 0-40 d). Ten patients (21%) had recurrence of acute pancreatitis. Three patients (6%) were subsequently diagnosed with pancreatic cancer. Conclusions: A definite etiology could be identified in most patients with CD with acute pancreatitis. Gallstones and alcohol accounted for more than one third of cases, whereas CD, 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.

AB - Background: Acute pancreatitis has occasionally been associated with Crohn's disease (CD), but whether a causal association exists remains unclear. We sought to determine the frequency of etiologies in a consecutive series of patients with CD with acute pancreatitis. Methods: A centralized diagnostic index was used to identify all patients with CD with acute pancreatitis that were evaluated at Mayo Clinic Rochester between 1976 and 2001. Both diagnoses were made or confirmed at our institution. Records were abstracted for demographics, presenting symptoms, diagnostic tests, risk factors of pancreatitis, treatment, and follow-up. Results: Forty-eight patients with CD with pancreatitis were identified. The median age at diagnosis of acute pancreatitis was 47 years (range, 31-91 yr). Forty-six (96%) met biochemical criteria for acute pancreatitis. The most sensitive radiographic tests were abdominal computed tomography (70%) and abdominal ultrasound (46%). The etiology of pancreatitis was considered to be gallstones (21%), significant alcohol intake (15%), use of purine analogs (13%), duodenal Crohn's involvement (12%), postendoscopic retrograde cholangiopancreatography complications (10%), postoperative complications (12%), use of other medications (4%) and idiopathic (8%). The median length of hospitalization was 7 days (range, 0-40 d). Ten patients (21%) had recurrence of acute pancreatitis. Three patients (6%) were subsequently diagnosed with pancreatic cancer. Conclusions: A definite etiology could be identified in most patients with CD with acute pancreatitis. Gallstones and alcohol accounted for more than one third of cases, whereas CD, 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.

KW - 5-aminosalicylate toxicity

KW - Acute pancreatitis

KW - Azathioprine toxicity

KW - Crohn's disease

UR - http://www.scopus.com/inward/record.url?scp=27944498556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27944498556&partnerID=8YFLogxK

U2 - 10.1097/01.MIB.0000186485.30623.ad

DO - 10.1097/01.MIB.0000186485.30623.ad

M3 - Article

C2 - 16306770

AN - SCOPUS:27944498556

VL - 11

SP - 1080

EP - 1084

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 12

ER -