Pancreatitis associated with duodenal Crohn's disease.

The fourth reported patient with acute pancreatitis associated with Crohn's disease of the duodenum is presented and the clinical features compared with previously described cases. The pathogenesis of the pancreatitis was not clear but the inflammatory process was found to involve the ampulla of Vater making ampullary incompetence with duodenal reflux or ampullary obstruction the most likely mechanisms. High dose prednisone combined with nasogastric suction and subsequently long-term Cimetidine resulted in a rapid improvement which has been maintained.