Chronic pancreatitis as presentation of Crohn's disease in a child

World J Gastroenterol. 2013 Aug 21;19(31):5204-6. doi: 10.3748/wjg.v19.i31.5204.


It is reported that a pancreatic disease may precede the diagnosis of inflammatory bowel disease (IBD) both in children and in adults. Idiopathic chronic pancreatitis, however, occasionally co-exists with the IBD, mainly at pediatric age. We report a case of a patient who progressively developed the features of a chronic pancreatitis, before the diagnosis of Crohn's Disease (CD). Ten months after the onset of the first episode of pancreatitis the patient developed bloody diarrhea, mucus stools and biochemical findings of inflammation. The colonoscopy revealed a diffuse colitis without involvement of the last loop and the gastroscopy showed inflammation of the iuxta-papillary area. The histological findings confirmed the diagnosis of CD that involved the colon and the duodenum. In conclusion, in children the idiopathic chronic pancreatitis may be an unusual presentation of CD. Thus, if other known cause of chronic pancreatitis are not found, a not invasive work up to exclude the IBD should be warranted. An early coincidental diagnosis of the IBD may delay the progression of the pancreatic disease.

Keywords: Bloody diarrhea; Crohn’s Disease; Inflammatory bowel disease; Pancreatic disease; Pediatric age.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Colonoscopy
  • Crohn Disease / complications*
  • Crohn Disease / diagnosis
  • Crohn Disease / therapy
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Gastroscopy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Pancreatitis, Chronic / diagnosis
  • Pancreatitis, Chronic / etiology*
  • Pancreatitis, Chronic / therapy
  • Predictive Value of Tests
  • Recurrence
  • Sphincterotomy, Endoscopic / instrumentation
  • Stents
  • Treatment Outcome


  • Gastrointestinal Agents
  • Immunosuppressive Agents

Supplementary concepts

  • Pediatric Crohn's disease