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Acute Recurrent Pancreatitis in Association with Gallbladder Agenesis: 1335

The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S764-S765 [Peer Reviewed Journal]

Copyright Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins Oct 2018 ;ISSN: 0002-9270 ;EISSN: 1572-0241 ;DOI: 10.14309/00000434-201810001-01335

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  • Title:
    Acute Recurrent Pancreatitis in Association with Gallbladder Agenesis: 1335
  • Author: Winkle, Sean ; Multani, Monica L. ; Riaz, Amir ; Skrove, Jamie L. ; Panicker, Linoj ; Javed, Faiz ; Sarol, Juan ; Sobrado, Javier
  • Subjects: Abdomen ; Congenital diseases ; Gallbladder ; Pancreatitis
  • Is Part Of: The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S764-S765
  • Description: Gallbladder agenesis (GA) is an unusual anatomical finding with an incidence of 10-65 per 100, 000 population. This rare congenital anomaly has a female predominance and approximately 23% of people affected are symptomatic. GA can be associated with biliary tract abnormalities and malformations in the gastrointestinal, genitourinary, or cardiovascular systems. We present a case in which a patient with GA has frequent episodes of acute pancreatitis. Acute recurrent pancreatitis (ARP) is commonly associated with alcohol abuse or gallstone disease but can have hereditary or congenital causes as well. Gallbladder disease and acute pancreatitis often coincide; hence, there is limited data correlating GA with acute pancreatitis. A 62 year old female was admitted to the hospital for generalized weakness. She has a past medical history of ARP leading to multiple hospital admissions. A biliary stent was previously placed via endoscopic retrograde cholangiopancreatography (ERCP) that showed multiple filling defects and several stones within the common bile duct (CBD). Another episode of ARP led to a second ERCP in which the stent was removed and a sphincterotomy was performed. Following admission, she began experiencing abdominal pain associated with nausea, vomiting, and fever. On initial work-up lipase, amylase, and ESR were increased. Abdominal ultrasound revealed an edematous pancreas with intrahepatic biliary dilation and an abdominal CT showed an absent gallbladder. A magnetic resonance cholangiopancreatography showed minimal peripancreatic fluid, a CBD diameter of 7.9mm, and no evidence of choledocholithiasis. These findings suggested acute interstitial pancreatitis. She was medically optimized and further care was provided on an outpatient basis. Genetic tests for hereditary causes of ARP are currently pending. Only two other cases of GA with concomitant acute pancreatitis have been reported. This patient with GA is experiencing multiple episodes of recurrent pancreatitis with no known etiology. She has no history of alcohol abuse, prior abdominal surgeries, or additional structural variances that would lead to pancreatic pathology. The pathology of ARP associated with GA may be due to increased biliary pressure and decreased production of biliary mucus or a related hereditary gene mutation. However, due to the lack of literature on the two conditions occurring in the same patient, further study would be required to confirm these associations.
  • Publisher: New York: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
  • Language: English
  • Identifier: ISSN: 0002-9270
    EISSN: 1572-0241
    DOI: 10.14309/00000434-201810001-01335
  • Source: AUTh Library subscriptions: ProQuest Central
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