Clin Endosc.  2014 Nov;47(6):579-583. 10.5946/ce.2014.47.6.579.

Acute Pancreatitis Due to a Duodenal Ulcer

• Pyeon SI
• Hwang JH
• Kim YT
• Lee BS
• Lee SH
• Lee JN
• Cheong JH
• Oh KJ

• KMID: 2134500
• DOI: http://doi.org/10.5946/ce.2014.47.6.579

Abstract

Duodenal ulcers and acute pancreatitis are two of the most commonly encountered gastrointestinal diseases among the general population. However, duodenal ulcer-induced pancreatitis is very rarely reported worldwide. This report elaborates on a distinct medical treatment that contributes to partial or complete treatment of acute pancreatitis induced by a duodenal ulcer scar.

Keyword

Duodenum; Ulcer; Scar; Pancreatitis; Stent

MeSH Terms

Cicatrix
Duodenal Ulcer*
Duodenum
Gastrointestinal Diseases
Pancreatitis*
Stents
Ulcer

Figure

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  Fig. 1 Computed tomography findings. Mild pancreatitis with subtle peripancreatic fluid collection, especially around the pancreatic head is observed.

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  Fig. 2 Endoscopic ultrasonography image. (A) No dilatation of the common bile duct is observed. (B) A dilatation of the pancreatic duct and pancreatic parenchymal mass are not observed. (C) Gallbladder stones or sludge are not observed.

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  Fig. 3 First endoscopic retrograde cholangiopancreatoscopy finding. (A) A linear ulcer scar on the duodenal second portion, which is accompanied with fibrotic changes around the lesion, is circumferentially observed. (B) However, any specific shapes of the ampulla are not found.

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  Fig. 4 Magnetic resonance cholangiopancreatography findings. Normal anatomy with acute pancreatitis.

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  Fig. 5 Findings from the second endoscopic retrograde cholangiopancreatoscopy (ERCP) 7 days after the first ERCP. (A) Before the insertion of the cannula. (B) Several attempts of cannulation were made by the use of an ERCP catheter tip before finally succeeding. (C) Seven French plastic stents were inserted in the pancreatic duct.

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  Fig. 6 Findings from the second endoscopic retrograde cholangiopancreatoscopy (ERCP) 7 days after the first ERCP. (A) Common bile duct. (B) Pancreatic duct.

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