World J Gastroenterol. 2013 Aug 21;19(31):5204-6. doi: 10.3748/wjg.v19.i31.5204.
It is reported that a pancreatic disease may precede the diagnosis of inflammatory bowel disease (IBD) both in children and in adults. Idiopathic chronic pancreatitis, however, occasionally co-exists with the IBD, mainly at pediatric age. We report a case of a patient who progressively developed the features of a chronic pancreatitis, before the diagnosis of Crohn's Disease (CD). Ten months after the onset of the first episode of pancreatitis the patient developed bloody diarrhea, mucus stools and biochemical findings of inflammation. The colonoscopy revealed a diffuse colitis without involvement of the last loop and the gastroscopy showed inflammation of the iuxta-papillary area. The histological findings confirmed the diagnosis of CD that involved the colon and the duodenum. In conclusion, in children the idiopathic chronic pancreatitis may be an unusual presentation of CD. Thus, if other known cause of chronic pancreatitis are not found, a not invasive work up to exclude the IBD should be warranted. An early coincidental diagnosis of the IBD may delay the progression of the pancreatic disease.
据报道，在儿童和成人中，胰腺疾病可能先于炎症性肠病（IBD）诊断。然而，特发性慢性胰腺炎偶尔与 IBD 共存，主要发生在儿科年龄。我们报告了一例患者，在诊断克罗恩病（CD）之前，逐渐出现慢性胰腺炎的特征。胰腺炎首次发作后 10 个月，患者出现血性腹泻、黏液便和炎症的生化发现。结肠镜检查显示弥漫性结肠炎，不累及最后一环，胃镜检查显示乳头旁区域炎症。组织学发现证实了累及结肠和十二指肠的 CD 的诊断。总之，在儿童中，特发性慢性胰腺炎可能是 CD 的一种不常见表现。因此，如果未发现其他已知的慢性胰腺炎病因，应进行非侵入性检查以排除 IBD。IBD 的早期偶然诊断可能会延迟胰腺疾病的进展。
