2017-09-14 12:40:48 UTC

Image Challenge: A Rare Cause of Pancreatitis

Sept. 14, 2017

What caused a patient — with a history of Behçet disease but no symptoms for seven years — incapacitating abdominal pain?

Gastroenterology Clinical Image Challenge: A 32-year-old woman with a past medical history relevant for active smoking and Behçet disease diagnosed 15 years before, with vascular, articular manifestations and an acute pancreatitis that was attributed to ischemia owing to Behçet vasculitis (celiac trunk dissection). She was medicated with cyclophosphamide and corticosteroids.

In the following years, she consulted the emergency department for several episodes of abdominal pain with mild elevation of serum amylase (4× the upper limit of normal) and lipase (4.5× the upper limit of normal). After seven years without any symptoms, she consulted once again for incapacitating abdominal pain and very mild hyperamylasemia (1.5× the upper limit of normal).

What is the diagnosis and the most likely etiology?

To find out the diagnosis, read the full case in Gastroenterology or download our Clinical Image Challenge app through AGA App Central, which features new cases each week. Sort and filter by organ, most popular or favorites. AGA App Central is available in both the Apple App Store and Google Play.