A Case of Acute Pancreatitis Developing After Upper Gastrointestinal Endoscopy - A Rare Post-Procedural Complication

Sep 30, 2026

Acute pancreatitis is a rare but clinically significant complication following upper gastrointestinal endoscopy. Its diagnosis may be missed when abdominal symptoms are attributed to the initial reason for endoscopy. While endoscopy is commonly reliable, postprocedural pancreatitis is rarely reported and its mechanisms remain incompletely understood. Proposed causes include mechanical irritation, air-inflation–related pressure effects, or pancreatic duct obstruction. This report describes a 57-year-old woman whose symptoms developed shortly after endoscopy, confirmed by elevated pancreatic enzymes and imaging, managed conservatively with improvement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Abstract

Introduction

Case Presentation

Review began 10/21/2025 Review ended 12/01/2025 Published 12/09/2025 © Copyright 2025 Çoban et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98812 Open Access Case Report A Case of Acute Pancreatitis Developing After Upper Gastrointestinal Endoscopy: A Rare PostProcedural Complication Hasan H. Çoban 1, Güngör Sitar 1, Elif N. Yilmaz 1, Semih Eker 1, Ayşenur Ünlütürk 1 1. Internal Medicine, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, TUR Corresponding author: Hasan H. Çoban, [cobanhhakan@gmail.com](cobanhhakan@gmail.com) Abstract Acute pancreatitis is a rare but clinically significant complication of upper gastrointestinal endoscopy. Its diagnosis can be easily overlooked if abdominal symptoms are associated with the primary indication for the procedure. Although endoscopy is generally considered a reliable diagnostic tool, postprocedural pancreatitis has rarely been described in the literature, and its underlying mechanisms are not yet fully understood. Possible explanations include mechanical irritation from gastric or duodenal manipulations, increased intraluminal pressure due to air inflation, or induction of procedure-related pancreatic duct obstruction in susceptible patients. We report the case of a 57-year-old woman who underwent upper gastrointestinal endoscopy because of persistent vomiting and increasingly severe abdominal pain for a week. On presentation, she complained of a streaky, posteriorly directed upper abdominal pain andrecurrent nausea and vomiting. Laboratory tests revealed elevated lipase (264 .8 U/L; reference range: 13-60) and amylase (201 U/L; reference range: 28-100) . Physical examination revealed marked tenderness in the upper abdomen without guarding or rebound tenderness. Imaging studies confirmed the diagnosis of acute pancreatitis. The patient was admitted to the internal medicine department and treated conservatively with analgesics, fluid therapy, and bowel rest. Her symptoms gradually improved, and she was discharged home in stable condition. This case highlights the importance of upper gastrointestinal endoscopy as a possible (albeit rare) trigger for acute pancreatitis, especially when new or worsening abdominal pain occurs shortly after the procedure. Given the limited number of published cases and the uncertainty of causal relationships, documentation of such cases is important to increase clinical awareness, guide diagnostic suspicion, and contribute to a better understanding of this rare complication. Categories: Internal Medicine, Gastroenterology Keywords: acute pancreatitis (ap), gastritis, gi endoscopy, polypectomy, rare complication Introduction Acute pancreatitis originates from a variety of aetiologies, including gallstones, alcohol abuse, hypertriglyceridemia, medications, autoimmune conditions, and invasive procedures. Diagnosis is based on at least two of the following Atlanta criteria: characteristic abdominal pain, serum lipase or amylase levels ≥3 times the upper limit of normal, and radiographic evidence of pancreatitis [1] . Initial treatment includes bowel rest, intravenous hydration, and gradual reintroduction of oral intake. Further imaging is often indicated [2] . Although upper gastrointestinal endoscopy is generally considered a safe diagnostic procedure, acute pancreatitis occurring after endoscopy is exceedingly rare, and its mechanism is not fully understood. Proposed contributors include prolonged procedure time, repeated repositioning, and excessive air insufflation, all of which may result in mechanical or pressure-related pancreatic irritation. This report documents a rare case of acute pancreatitis following endoscopy in a p

FAQs

Why can acute pancreatitis after endoscopy be overlooked?

Abdominal symptoms after endoscopy may be incorrectly attributed to the original indication for the procedure. This can delay recognition despite the clinical significance of pancreatitis.

What mechanisms are proposed for pancreatitis developing after upper gastrointestinal endoscopy?

Possible explanations include mechanical irritation during gastric or duodenal manipulation, increased intraluminal pressure from air inflation, and procedure-related pancreatic duct obstruction in susceptible patients.

How was the reported patient managed and what was the outcome?

The patient was admitted and treated conservatively with analgesics, fluid therapy, and bowel rest. Symptoms gradually improved, and she was discharged in stable condition.

Sep 30, 2026

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