Pancreatitis causing death in bulimia nervosa.
OBJECTIVE
We report the case of a 19-year-old woman with bulimia nervosa who died of acute hemorrhagic pancreatitis. Our objective is to raise awareness that because the symptoms of both conditions are very similar, the pre-existence of an eating disorder should not distract physicians from the possibility that potentially lethal acute pancreatitis may coexist.


METHODS
The study includes autopsy results and a review of the literature.


RESULTS
Pancreatitis usually presents with abdominal pain, nausea, and vomiting.


CONCLUSIONS
In patients with eating disorders who may already have exhibited these symptoms pancreatitis may not be considered. Elevated serum amylase values may occur in subjects with bulimia nervosa without pancreatitis. If the serum amylase value is elevated, pancreatitis can be confirmed by measuring the levels of serum lipase, trypsinogen, pancreatic isoenzyme of amylase, or by abdominal computerized tomography (CT).
Birmingham
Carl Laird
CL
Department of Psychiatry, University of British Columbia, Vancouver, B.C. V6Z 1Y6, Canada. clbirm@interchange.ubc.ca
Boone
Sharon
S
D000328:Adult; D000681:Amylases / Q000097:blood; D002032:Bulimia / Q000097:blood / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010195:Pancreatitis / Q000097:blood / Q000150:complications*
D000681:Amylases