title: Pancreatic cancer causing acute pancreatitis: a comparative study with cancer patients without pancreatitis and pancreatitis patients without cancer.
abstract: OBJECTIVE
  Although pancreatic cancer produces upstream obstructive pancreatitis, acute pancreatitis is a less common manifestation of pancreatic cancer. This study aimed to clarify the subgroup of pancreatic cancer patients who present with an episode of acute pancreatitis (Group I) in comparison with a matched group of pancreatic cancer patients without pancreatitis (Group II) and another group of acute pancreatitis patients without pancreatic cancer (Group III).
  
  
  METHODS
  This was a retrospective comparative study of 18 patients in Group I, 300 patients in Group II and 141 patients in Group III.
  
  
  RESULTS
  The mean age of Group I was 63.7 years and the male to female ration was 1:0.3. Serum CA 19-9 levels were elevated in 80 %. The main pancreatic duct was incompletely obstructed in 7 patients. There were no significant differences in location of tumor, clinical stage, resection rate and survival months between Group I and II. Acute pancreatitis secondary to pancreatic cancer was more likely to be mild (94 vs. 72 %,p < 0.05) and relapsed (39 vs. 16 %,p < 0.05) compared with Group III.
  
  
  CONCLUSIONS
  Anatomic evaluation of the pancreas should be performed in patients with acute pancreatitis with no obvious etiology, even if the pancreatitis is mild, to search for underlying malignancy.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Minato
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Taku
authors.initials: T
authors.lastname: Tabata
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hara
authors.forename: Sawako
authors.initials: S
authors.lastname: Kuruma
authors.forename: Kazuro
authors.initials: K
authors.lastname: Chiba
authors.forename: Go
authors.initials: G
authors.lastname: Kuwata
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Hideto
authors.initials: H
authors.lastname: Egashira
authors.forename: Koichi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Itaru
authors.initials: I
authors.lastname: Saito
authors.forename: Yuka
authors.initials: Y
authors.lastname: Endo
authors.forename: Satomi
authors.initials: S
authors.lastname: Koizumi
authors.forename: Junko
authors.initials: J
authors.lastname: Fujiwara
authors.forename: Takeo
authors.initials: T
authors.lastname: Arakawa
authors.forename: Kumiko
authors.initials: K
authors.lastname: Momma
authors.forename: Masanao
authors.initials: M
authors.lastname: Kurata
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
keywords: acute pancreatitis; initial symptom; pancreatic cancer