Usefulness of Fecal Calprotectin Measurement in a Pediatric Patient with Crohn’s Disease

Acute pancreatitis in children in Japan is often caused by an anatomical abnormality of the pancreatic and bile duct, resulting in fever, abdominal pain, vomiting, diarrhea, and other symptoms. Crohn's disease, however, is a chronic granulomatous inflammatory bowel disease with ulcerative lesions of the intestinal tract of unknown cause that occurs mainly in young people, with symptoms similar to those of acute pancreatitis. We report a case of acute pancreatitis diagnosed in a patient not only with incomplete fusion of the pancreatic duct but also with Crohn's disease. A 14-year-old girl, healthy by nature, presented to our hospital with complaints of abdominal pain and diarrhea. She was initially diagnosed as having acute pancreatitis due to incomplete pancreas divisum. However, a high level of fecal calprotectin led to endoscopic examination, which resulted in the diagnosis of Crohn's disease. Fecal calprotectin can be useful in the diagnosis of inflammatory bowel disease associated with acute pancreatitis in children. Although the relationship between inflammatory bowel disease and acute pancreatitis has not yet been clarified, we suggest that in the present case, acute pancreatitis may have manifested as a complication of Crohn's disease and an underlying case of incomplete pancreas divisum.