Diabetic ketoacidosis in a patient with chronic calcific pancreatitis after minor papilla stent insertion

Abstract

Chronic pancreatitis is characterized by irreversible destruction and fibrosis of pancreatic parenchyma, ultimately leading to exocrine and endocrine deficiency. Although patients with chronic pancreatitis are particularly prone to hypoglycemia, ketoacidosis is distinctly uncommon, even if insulin treatment is withdrawn.1–3 However, ketoacidosis can occur during stress and after correction of maldigestion by administration of potent pancreatic enzyme supplements.4 A case is reported of pancreas divisum, alcohol-induced chronic calcific pancreatitis and diabetes, in which the presentation was diabetic ketoacidosis within 3 months of stent insertion via the minor papilla for chronic intractable pain.