title: Duodenal Loop Obstruction as an Unusual Cause of Acute Pancreatitis: A Case Series.
abstract: Duodenal loop obstruction is an unusual cause of acute pancreatitis. Increased intraluminal pressure hinders pancreatic flow, causing dilatation of the pancreatic duct and inducing acute pancreatitis. We experienced three cases of acute pancreatitis that resulted from duodenal loop obstruction after (1) an esophagectomy with gastric pull-up procedure for esophageal cancer, (2) a gastrectomy with Billroth I reconstruction for gastric cancer, and (3) a gastrojejunostomy for abdominal trauma. An abdominal CT scan revealed a distended duodenal loop, dilated pancreatic duct, and inflamed pancreas with fluid collection. Acute pancreatitis with duodenal loop obstruction was diagnosed by abdominal pain, elevated serum amylase/lipase, and abdominal CT findings. Immediate decompression with a nasogastric tube was performed, and all patients showed improvement within one week after admission. Each patient was followed up for more than two years without recurrence. Our findings suggest the usefulness of nasogastric tube decompression as the first line of treatment for acute pancreatitis related to duodenal loop obstruction.
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Hyeonmin
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Yonghyeok
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Hyewon
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Jae Kyu
authors.initials: JK
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Taeyoung
authors.initials: T
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Joung Ho
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000208:Acute Disease; D000368:Aged; D000681:Amylases / Q000097:blood; D019299:Decompression, Surgical; D004380:Duodenal Obstruction / Q000150:complications*; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D008049:Lipase; D000681:Amylases
keywords: Decompression; Duodenal obstruction; Pancreatitis, acute