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. 2022 Jun;55(12):1478-1491.
doi: 10.1111/apt.16949. Epub 2022 May 3.

Systematic review-pancreatic involvement in inflammatory bowel disease

Sara Massironi  1   2 , Ilaria Fanetti  3 , Chiara Viganò  1   2 , Lorena Pirola  1   2 , Maria Fichera  1   2 , Laura Cristoferi  1   2 , Gabriele Capurso  4 , Pietro Invernizzi  1   2 , Silvio Danese  5
Affiliations

Systematic review-pancreatic involvement in inflammatory bowel disease

Sara Massironi et al. Aliment Pharmacol Ther. 2022 Jun.

Abstract
in English, Somali

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated disorder of the gut with frequent extra-intestinal complications. Pancreatic involvement in IBD is not uncommon and comprises a heterogeneous group of conditions, including acute pancreatitis (AP), chronic pancreatitis (CP), autoimmune pancreatitis (AIP) and pancreatic exocrine insufficiency (PEI); however, data on such an association remain sparse and heterogeneous.

Method: PubMed/MEDLINE and EMBASE databases were searched for studies investigating pancreatic involvement in patients with IBD.

Results: Four thousand one hundred and twenty-one records were identified and 547 screened; finally, 124 studies were included in the review. AP is the most frequent pancreatic manifestation in IBD; the majority of AP cases in IBD are due to gallstones and drugs but cases of idiopathic AP are increasingly reported. AIP is a rare disease, but a strong association with IBD has been demonstrated, especially for type 2 and ulcerative colitis. The pathogenetic link between IBD and AIP remains unclear, but an immune-mediated pathway seems plausible. An association between CP and PEI with IBD has also been suggested, but data are to date scarce and conflicting.

Conclusion: This is the first systematic review of the association between IBD and pancreatic diseases. Gallstones and drugs should be considered the most probable causes of AP in IBD, with type 2 AIP also being possible.

Systematic review. Pancreatic involvement in inflammatory bowel disease (IBD). The wide spectrum of pancreatic involvement in patients with IBD may represent a challenge. From the 124 studies analyzed, acute pancreatitis (AP) is the most frequent pancreatic manifestation in IBD; the majority of AP cases in IBD are due to gallstones and drugs, but cases of idiopathic AP are increasingly reported. Autoimmune pancreatisis is a rare disease, but a strong association with IBD has been demonstrated, especially for type 2 and ulcerative colitis.

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Figures

FIGURE 1
FIGURE 1
PRISMA 2020 diagram showing the study selection process, with the results divided by topics
FIGURE 2
FIGURE 2
Endoscopic ultrasound appearance of autoimmune pancreatitis (AIP). The image shows the head of the pancreas examined from the duodenum with a diffuse coarse and hypoechoic appearance (sausage‐shaped) in a patient with type 2 AIP. The main pancreatic duct was normal (calliper 1.6 mm)
FIGURE 3
FIGURE 3
The spectrum of pancreatic manifestation in inflammatory bowel disease (IBD)
See this image and copyright information in PMC

Comment in

References

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