Post-ERCP Pancreatitis With Normal Serum Amylase Level : A Case Report

Abstract

Introduction: Endoscopic Retrograde Cholangiopancreatography (ERCP) could be mentioned as the most complex endoscopic procedure and is widely used for diagnosis and treatment of biliary and pancreatic disease. Pancreatitis is the most common complication following ERCP which may be life threatening. This article presents an old woman diagnosed as post-ERCP pancreatitis without increasing in serum amylase level.

Case Presentation: A 69 years old woman with a history of cholecystectomy a few years ago, was presented with abdominal pain in epigastric region. Abdominal sonography revealed a dilated CBD (11 mm in diameter) so MRCP performed for diagnosis. There were several stones in CBD, so the patient underwent therapeutical ERCP. Six hours after the procedure, she complained of severe abdominal pain in RUQ and tenderness. Serum amylase was 51 mg/dL. An abdominal CT scan revealed pancreatitis.

Discussion: Pancreatitis is the most common complication following ERCP which indicates with abdominal pain in RUQ and increasing in serum amylase level more than 3 fold of normal upper limit. In this case, pancreatitis occurred without laboratory findings consistent with the diagnosis which is not a common occurrence.