La pancréatite aiguë au cours de la rectocolite ulcérohémorragique : complication rare de la mésalazine

Abstract

Acute pancreatitis secondary to mesalazine is rare. Thirty-nine cases were described. We report a new case of pancreatitis during treatment of distal ulcerative colitis (UC) with mesalazine in a 38-year-old woman, without alcohol consumption. Treatment with enema and oral mesalazine was started. One week later, the patient was admitted for pancreatic epigastric pain; lipasemia was raised to threefold the upper normal limit. Ultrasound and abdominal CT scan showed an enlarged heterogeneous pancreatic head without Wirsung or biliary ducts abnormalities; treatment was stopped with regression of symptomatology as well as normalization of lipasemia after 10 days. Acute pancreatitis secondary to mezalasine is a rare side effect in the treatment of chronic inflammatory bowel diseases. This diagnosis must be evoked in any patient receiving mesalazine and presents pancreatic epigastric pain after excluding other causes of pancreatitis, particularly autoimmune etiology.