Gastroenterology, Hepatology, and Clinical Nutrition, Saint Peters University Hospital, New Brunswick, NJ, USA.
J Clin Gastroenterol. 2010 Apr;44(4):246-53. doi: 10.1097/MCG.0b013e3181cadbe1.
Crohn's disease and ulcerative colitis, together popularly known as inflammatory bowel disease (IBD), are characterized by a number of extraintestinal manifestations. Although infrequent, acute pancreatitis, and less often chronic pancreatitis, may occur as a result of the disease itself or secondary to the medications used in the treatment. The increased incidence of acute pancreatitis in Crohn's disease can be explained based on the high predisposition to cholesterol as well as pigment stones as a result of ileal disease, anatomic abnormalities of the duodenum, immunologic disturbances associated with IBD, and, above all, to the side effects of many medications used in the treatment. Sulfasalazine, 5-aminosalicylic acid, azathioprine, and 6-mercaptopurine are well known to cause acute pancreatitis as a result of a possible idiosyncratic mechanism. Crohn's disease and ulcerative colitis share many clinical manifestations and treatment modalities. Nonspecific elevations of serum pancreatic enzymes in IBD make it difficult to avoid over diagnosis of acute pancreatitis, particularly in patients with Crohn's disease who suffer from abdominal pain often. The IBD-pancreas association is further reflected in many reports of exocrine as well as endocrine pancreatic insufficiency.
克罗恩病和溃疡性结肠炎，通常被称为炎症性肠病（IBD），其特征是存在多种肠外表现。尽管不常见，但急性胰腺炎，以及较少见的慢性胰腺炎，可能是由于疾病本身或治疗中使用的药物引起的。克罗恩病中急性胰腺炎发病率增加的原因可以用以下几点解释：回肠疾病导致胆固醇和色素结石的高易感性、十二指肠解剖异常、与 IBD 相关的免疫紊乱，以及最重要的是，与治疗中使用的许多药物的副作用有关。柳氮磺胺吡啶、5-氨基水杨酸、硫唑嘌呤和 6-巯基嘌呤由于可能存在的特发性机制而被公认为会引起急性胰腺炎。克罗恩病和溃疡性结肠炎有许多共同的临床表现和治疗方式。IBD 中血清胰腺酶的非特异性升高使得难以避免对急性胰腺炎的过度诊断，特别是在经常出现腹痛的克罗恩病患者中。IBD-胰腺的相关性还反映在许多关于外分泌和内分泌胰腺功能不全的报告中。
