Clinical characteristics of acute pancreatitis in patients with inflammatory bowel disease: a nationwide survey in Japan
BACKGROUND: Patients with inflammatory bowel disease (IBD) are at increased risk of acute pancreatitis (AP). However, the clinical characteristics of AP in IBD and the differences between ulcerative colitis (UC) and Crohn's disease (CD) remain unclear. METHODS: We conducted a nationwide, multicenter, retrospective study at 28 institutions in Japan. Patients ≥ 16 years with UC or CD treated between 2012 and 2021 were included. We assessed the characteristics of AP in IBD, including differences between UC and CD. We also compared UC and CD patients with and without AP. RESULTS: Among 24,849 patients with IBD (16,233 UC and 8,616 CD), 342 (1.4%) developed AP. Among these AP cases, severe AP and mortality were observed in 7.6% and 0.6%, respectively. Drug-induced AP was the most common etiology (55.6%), and autoimmune pancreatitis (AIP) ranked third (10.8%). Compared with UC, CD patients with AP had higher rates of intensive care unit admission (P = 0.002) and severe AP (P = 0.003). CD (odds ratio, 2.96; P = 0.02) and drug-induced or AIP etiology (odds ratio, 0.19; P < 0.001) were associated with severe AP. UC patients with AP had higher rates of pancolitis (P < 0.001), extraintestinal manifestations (P = 0.001), and steroid dependence (P = 0.006) than those without AP. CONCLUSIONS: AP in IBD showed distinct clinical characteristics compared with AP in the general population. CD patients may develop more severe AP than UC, whereas UC patients with AP may have more aggressive and/or refractory disease features compared with those without AP.
Authors
- Soichiro Ishihara (ORCID: https://orcid.org/0000-0003-0543-0045)
- M Naganuma
- Sakiko Hiraoka (ORCID: https://orcid.org/0000-0002-9796-6930)
- Kazuyuki Narimatsu (ORCID: https://orcid.org/0000-0002-1620-5575)
- Ami Kawamoto (ORCID: https://orcid.org/0000-0002-8549-4999)
- Takashi Kagaya (ORCID: https://orcid.org/0000-0003-0819-632X)
- Shinichiro Shinzaki (ORCID: https://orcid.org/0000-0002-7051-618X)
- Tetsu Kinjo (ORCID: https://orcid.org/0000-0002-3996-3942)
- Yoichi Kakuta (ORCID: https://orcid.org/0000-0002-7042-009X)
- T Maruo
- Noritaka Takatsu (ORCID: https://orcid.org/0000-0002-1967-5169)
- Takuto Saiki (ORCID: https://orcid.org/0000-0002-8595-9442)
- Shojiro Yamamoto
- Katsuya Endo (ORCID: https://orcid.org/0000-0002-6449-8392)
- Tetsuya Takagawa (ORCID: https://orcid.org/0000-0001-7335-6962)
- Tetsuya Takikawa (ORCID: https://orcid.org/0000-0002-6214-7337)
- K Kikuta
- F Kinjo
- Shoko Igawa
- Kazuki Kurimura
- Yoki Furuta (ORCID: https://orcid.org/0000-0002-2194-5236)
- Takashi Tashiro
- Serina Haruyama
- H NAKASE
- Ryota Hokari
- A Nishida
- Shinji Ota
- Japan Pancreatitis Study Group
- Makoto Sasaki
- Hiroshi Nagai
- Tomohisa Takagi
- Junji Umeno
- Daiki Shirakura
- Atsushi Masamune
- Takayuki Matsumoto
- Mikihiro Fujiya
- Kazuichi Okazaki
- Tadakazu Hisamatsu
- Takuya Ishikawa
- Masanao Nakamura
- Hirotake Sakuraba
- Takanori Sano
- Mitsuhiro Kawano
- Shin-ichiro Hagiwara
- Katsuyoshi Matsuoka
Institutions
- University of Miyazaki (JP)
- Kansai Medical University (JP)
- Toho University (JP)
- Kyushu University (JP)
- Hyogo Medical University (JP)
- Sapporo Medical University (JP)
- Hirosaki University (JP)
- Asahikawa Medical University (JP)
- Shiga University of Medical Science (JP)
- Okayama University (JP)
- Aichi Medical University (JP)
- Kanazawa Medical University (JP)
- Iwate Medical University (JP)
- Kyorin University (JP)
- Tohoku University (JP)
- Yokohama City University Medical Center (JP)
- Fukuoka University (JP)
- Kyoto Prefectural University of Medicine (JP)
- Nagoya University Hospital (JP)
- Kanazawa Medical Center (JP)
- Osaka Women's and Children's Hospital (JP)
- Okinawa Prefectural Chubu Hospital (JP)
- Toho University Medical Center Sakura Hospital (JP)
- Tohoku Medical and Pharmaceutical University Hospital (JP)
- University of the Ryukyus University Hospital (JP)
- National Defense Medical College (JP)
- The University of Tokyo (JP)
- Hyogo University (JP)
- Tohoku Medical and Pharmaceutical University (JP)
- Yokohama City University (JP)
- Kumamoto University (JP)
Publication Details
- Journal
- Journal of Gastroenterology
- Published
- 2026-06-29
- DOI
- https://doi.org/10.1007/s00535-026-02476-4
- Primary Topic
- Pancreatitis Pathology and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Ministry of Health, Labour and Welfare