Unraveling the Etiology of Acute Pancreatitis in the Context of Crohn’s Disease: Therapy versus Disease

Background: Acute pancreatitis is a medical condition defined by an inflamed pancreas that comes with certain signs and symptoms. This disease has a wide range of etiologies and possible clinical presentations. In the last decade, it has become increasingly popular to write about it in the specialized literature, as it was thrust into the limelight. Even though they have a low prevalence, Crohn’s disease and tumor necrosis factor-alpha that might affect the progression of the inflammatory disorder. Despite the huge therapeutic progress in the past few years, we should not forget about the physiopathology behind these complex medical situations. Case presentation: We present the case of a 64-year-old female, known with a medical history of Crohn’s disease under therapy with 5-aminosalicylic acid (5-ASA) therapy and Infliximab, who presented herself to the emergency room, with diffuse abdominal pain in the epigastrium and left hypochondrium, nausea, and alteration of general condition. After careful investigation, the patient was diagnosed with acute pancreatitis, and a CT scan was performed, showing a space-occupying mass located in the caudal pancreatic region and revealed the suspicion of a pancreatic neoplasm. Further investigation (Endoscopic Ultrasound with aspiration puncture) established the presence of a cyst in the caudal region of the pancreas. To highlight the complex situation of the medical condition of our patient, in addition, she has insulin-dependent type 2 diabetes, type 2 obesity and elevated TNF-alpha levels.