Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7514
Revised: January 26, 2014
Accepted: April 8, 2014
Published online: June 21, 2014
A 25-year-old man was admitted with the chief complaints of right flank pain, watery diarrhea, and fever. Blood tests revealed high levels of inflammatory markers, and infectious enteritis was diagnosed. A stool culture obtained on admission revealed no growth of any significant pathogens. Conservative therapy was undertaken with fasting and fluid replacement. On day 2 of admission, the fever resolved, the frequency of defecation reduced, the right flank pain began to subside, and the white blood cell count started to decrease. On hospital day 4, the frequency of diarrhea decreased to approximately 5 times per day, and the right flank pain resolved. However, the patient developed epigastric pain and increased blood levels of the pancreatic enzymes. Abdominal computed tomography revealed mild pancreatic enlargement. Acute pancreatitis was diagnosed, and conservative therapy with fasting and fluid replacement was continued. A day later, the blood levels of the pancreatic enzymes peaked out. On hospital day 7, the patient passed stools with fresh blood, and Campylobacter jejuni/coli was detected by culture. Lower gastrointestinal endoscopy performed on hospital day 8 revealed diffuse aphthae extending from the terminal ileum to the entire colon. Based on the findings, pancreatitis associated with Campylobacter enteritis was diagnosed. In the present case, a possible mechanism of onset of pancreatitis was invasion of the pancreatic duct by Campylobacter and the host immune responses to Campylobacter.
Core tip: A 25-year-old man was admitted with infectious enteritis. During the hospital stay, although the symptom of enteritis was improved, the patient developed epigastric pain and increased blood levels of the pancreatic enzymes, and was diagnosed acute pancreatitis. The patient passed fresh blood stools, and Campylobacter jejuni/coli was detected by culture. Based on the findings, pancreatitis associated with Campylobacter enteritis was diagnosed. Bacteria that cause gastroenteritis can also be causative agents for pancreatitis. When upper abdominal pain or increased levels of pancreatic enzymes not consistent with the course of gastroenteritis are observed, we need to consider concomitant pancreatitis.