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

## TL;DR

A rare case of acute pancreatitis occurred after an upper gastrointestinal endoscopy, highlighting the need for awareness of this uncommon complication.

## Contribution

This paper reports a rare case linking upper gastrointestinal endoscopy to acute pancreatitis, emphasizing its clinical significance.

## Key findings

- A 57-year-old woman developed acute pancreatitis following an upper gastrointestinal endoscopy.
- The case underscores the importance of considering endoscopy as a potential trigger for post-procedural pancreatitis.
- Conservative treatment led to symptom improvement and recovery.

## 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 and recurrent 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.