Acute Pancreatitis Following Routine Esophagogastroduodenoscopy: A Case Report and Literature Review

Background Acute pancreatitis following routine esophagogastroduodenoscopy (EGD) is extremely rare, with only a limited number of documented cases. While pancreatitis is a recognized complication of endoscopic retrograde cholangiopancreatography (ERCP), its occurrence after diagnostic or therapeutic EGD without ductal or ampullary manipulation is unexpected. Case Presentation A 42-year-old male with Lynch syndrome underwent surveillance EGD with a duodenal biopsy. Six hours later, he developed severe epigastric pain radiating to his back, accompanied by nausea. Laboratory testing revealed elevated lipase, and imaging confirmed acute interstitial pancreatitis. He remained hemodynamically stable and was managed conservatively with IV fluids, bowel rest, and analgesia, achieving full recovery within four days. Methods A systematic review was conducted using PubMed and Google Scholar, supplemented by manual reference checks. Results We identified 13 published cases of post-EGD pancreatitis between 1982 and 2023, with this case being the 14th. Symptom onset typically occurred within hours, most often between 4 and 6 hours. The mean age was 54.3 years (range 33–86), with equal distribution between sexes. Duodenal interventions, including biopsy, EMR, and polypectomy, were implicated in half of cases and appeared to carry higher risk. Outcomes were generally favorable with supportive care, though one patient experienced severe complications and another died. Length of stay ranged from 3 to 62 days. Conclusion Although rare, acute pancreatitis should be considered in patients with abdominal pain presenting after EGD, particularly following duodenal interventions. Early recognition and supportive management are essential for favorable outcomes.