Hastier P, Buckley M J, Peten E P, Demuth N, Dumas R, Demarquay J F, Caroli-Bosc F X, Delmont J P
Department of Hepato-Gastroenterology, Archet II University Hospital, Nice, France.
Am J Gastroenterol. 2000 Nov;95(11):3295-8. doi: 10.1111/j.1572-0241.2000.03213.x.
A variety of drugs have been reported to cause acute pancreatitis during the past 40 years. We report the first series of four cases of acute pancreatitis related to codeine ingestion. Four patients (three female, mean age 50.2 yr) presented with clinical, biochemical, and radiological evidence of acute pancreatitis. All four had ingested a therapeutic dose of codeine 1-3 h before the onset of abdominal symptoms. Unintentional rechallenge occurred in three cases and was followed by recurrence of acute pancreatitis in all three. All patients made a full recovery. All four patients had had a previous cholecystectomy. The likely underlying pathophysiological mechanism is codeine-induced spasm of the sphincter of Oddi combined with sphincter of Oddi dysfunction related to a previous cholecystectomy. Codeine ingestion leads to acute pancreatitis in some individuals. Previous cholecystectomy seems to predispose to codeine-induced pancreatitis.
在过去40年里，已有多种药物被报道可导致急性胰腺炎。我们报告了首例与可待因摄入相关的4例急性胰腺炎病例系列。4例患者（3名女性，平均年龄50.2岁）出现了急性胰腺炎的临床、生化和影像学证据。所有4例患者在出现腹部症状前1 - 3小时均摄入了治疗剂量的可待因。3例患者发生了意外再激发，随后这3例患者均再次出现急性胰腺炎。所有患者均完全康复。所有4例患者既往均行胆囊切除术。可能的潜在病理生理机制是可待因诱导的Oddi括约肌痉挛，以及与既往胆囊切除术相关的Oddi括约肌功能障碍。摄入可待因会导致部分个体发生急性胰腺炎。既往胆囊切除术似乎易引发可待因诱导的胰腺炎。
