Severe necrotizing pancreatitis following combined hepatitis A and B vaccination

Abstract

Necrotizing pancreatitis is a severe form of pancreatitis and is associated with substantial morbidity and mortality. We report a case of necrotizing pancreatitis that developed following combined hepatitis A and B vaccination. No other causes of pancreatitis could be determined. Although confirming the diagnosis is challenging, 3 main factors suggest a possible link to the vaccine: the chronology of the events, the patient's human leukocyte antigen genotype and the incongruent immune response to the vaccine components. This report serves to alert physicians to the possible development of necrotizing pancreatitis after vaccination.

Fig. 1: A contrast-enhanced CT scan at the level of splenic vein. The pancreatic head demonstrates heterogeneous enhancement with peripancreatic fat stranding and the pancreatic neck and body are replaced by a complex collection of non-enhancing tissue. Findings are consistent with phlegmonous pancreatitis with pancreatic necrosis.