Recurrent Acute Pancreatitis: Dangerous Etiology?

Jesús Espinel Diez*, Maria Eugenia Pinedo Ramos, Vanesa Ojeda Marrero and Maria Guerra del Rio Lang-Lenton

Recurrent Acute Pancreatitis: Dangerous Etiology.

Causes of RAP´s can be classified into mechanical, inherited, metabolic, toxic, drug-induced and miscellaneous. Pancreatic cancer is a rare etiology of AP. The prevalence of PC in individuals presenting with acute pancreatitis range from 0.9 to 3.6 %.

Few publications have reported some cases of RAP due to pancreatic cancer. They have tried to clarify the characteristics of this entity to facilitate its early diagnosis. Generally, RAP bouts are mild to moderate, requiring a few days of hospitalization.

The most common findings on US and CT scan are self-limited oedematous changes within the pancreas. We reported a case of pancreatic cancer that presented
with recurrent episodes of acute pancreatitis. Occasionally, in adult patients, AP can be the first manifestation of pancreatic cancer.

The average time established between the first episode of AP and the detection of PC is around 12 months. In our case, it was 11 months. Therefore, after successive episodes of acute pancreatitis with unexplained etiology, it is considered essential to follow-up these patients with EUS and TC for a long period of time for at least 12 months. This recommendation is of utmost importance in patients over the age of 40.

Pancreatic cancer can cause AP by an obstructive mechanism of the main pancreatic duct. Surprisingly, for several months significant changes in the main pancreatic duct and the pancreatic parenchyma were not observed. In the past, it has been difficult to classify the etiology of this relapsing disease.

Unexplained pancreatitis represents a diagnostic challenge, although after different investigations a cause is found in the majority of these patients. However, we must not forget the possibility of pancreatic cancer in adult patients.

Pancreas Open J. 2017; 2(1): 1-3. doi: 10.17140/POJ-2-108