Tsesmeli Niki E, Giannoulis Kleanthis E, Savopoulos Christos G, Vretou Eleni E, Ekonomou Ippoliti A, Giannoulis Elefterios K
1st Propedeutic Medical Department, AHEPA Hospital, Aristotle University of Thessaloniki, Stilponos Kyriakidi 1, Greece.
Eur J Gastroenterol Hepatol. 2007 Sep;19(9):805-6. doi: 10.1097/MEG.0b013e328133f2fb.
We present the first case of metronidazole-related acute pancreatitis during a relapse of ulcerative colitis. A 31-year-old male patient, with inflammatory bowel disease on mesalamine treatment for the last 5 months, suffered from a 48-h abdominal pain and nausea. He was also administered metronidazole during a relapse 5 days before. Laboratory and imaging investigation revealed acute pancreatitis. Conservative measures and metronidazole as well as mesalamine withdrawal resulted in complete recovery. Clinical remission of ulcerative colitis was obtained by prednisolone administration. Mesalamine was reintroduced and no recurrence was noticed for a year. Acute pancreatitis was mainly attributed to metronidazole owing to the absence of recurrence after mesalamine readministration, the time of onset after the initiation of metronidazole and the lower typical range between its onset and mesalamine exposure. Identifying acute pancreatitis as a possible consequence of a certain medication in inflammatory bowel disease patients may be particularly important to determine further treatment of their disease.
我们报告了溃疡性结肠炎复发期间甲硝唑相关性急性胰腺炎的首例病例。一名31岁男性患者，在过去5个月中接受美沙拉嗪治疗炎性肠病，出现了48小时的腹痛和恶心症状。他在复发前5天还服用了甲硝唑。实验室和影像学检查显示为急性胰腺炎。保守治疗以及停用甲硝唑和美沙拉嗪后患者完全康复。通过给予泼尼松龙实现了溃疡性结肠炎的临床缓解。重新使用美沙拉嗪后，一年内未再复发。由于重新使用美沙拉嗪后未复发、甲硝唑开始使用后的发病时间以及其发病与美沙拉嗪暴露之间较短的典型间隔时间，急性胰腺炎主要归因于甲硝唑。在炎性肠病患者中，将急性胰腺炎确定为某种药物可能产生的后果，对于确定其疾病的进一步治疗可能尤为重要。
