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Editor’s quiz: GI snapshot
Rare cause of recurrent acute pancreatitis: a double whammy from the pancreas and duodenum
  1. Zixuan He1,
  2. Shengbing Zhao1,
  3. Shuling Wang1,
  4. Shasha Song1,2,
  5. Zhaoshen Li1,
  6. Yu Bai1
  1. 1 Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
  2. 2 Department of Gastroenterology, Shougang Shuigang General Hospital, Liupanshui, China
  1. Correspondence to Dr Yu Bai, Department of Gastroenterology, Naval Medical University, Shanghai, China; baiyu1998{at}hotmail.com

https://doi.org/10.1136/gutjnl-2021-326704

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    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.

    Figure 1

    (A) Axial contrast-enhanced magnetic resonance image displaying enlarged pancreas with smooth margins and …

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    Footnotes

    • ZH, SZ, SW and SS are joint first authors.

    • ZL and YB are joint senior authors.

    • Contributors ZH, SZ and SW conceived this case report. SW and SS collected the clinical data of the patient. ZH wrote the original draft. ZL and YB reviewed and edited the manuscript. All authors contributed to the article and approved the submitted version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Author note ZH, SZ, SW and SS are co-first authors. ZL and YB are co-corresponding authors.

    • © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.