When Recurrent Pancreatitis Is Not Pancreatitis: Cyclic Vomiting Syndrome Masquerading as Acute Pancreatitis in a Young Adult
Abstract
Recurrent acute pancreatitis in young adults usually triggers an extensive evaluation for structural, genetic, metabolic, autoimmune, or toxic etiologies. However, pancreatic enzyme elevation and radiologic changes may occasionally arise from extra-pancreatic mechanisms, leading to diagnostic anchoring. We report a 20-year-old male who experienced four discrete episodes over a year, initially diagnosed as acute pancreatitis based on abdominal pain, vomiting, marked lipase elevation, and computed tomography findings. Each episode followed a highly stereotyped pattern beginning with prodromal uneasiness, progressing to repetitive vomiting, severe abdominal pain, diarrhea, and a post-episode phase of constipation with complete inter-episodic recovery. Subsequent attacks reproduced identical symptoms despite normal to mildly elevated pancreatic enzymes and imaging. The patient also reported recurrent sinus congestion, headaches, and muscle cramps, with a strong family history of migraine. An extensive evaluation, including heavy metal screening, autoimmune and immunologic testing, IgG4 levels, celiac serology, calcium and parathyroid hormone levels, ceruloplasmin, iron indices, cystic fibrosis transmembrane conductance regulator (CFTR) gene analysis, and porphyria testing, was unrevealing. Upper gastrointestinal endoscopy performed shortly after one attack demonstrated proximal gastric congestion without erosions or ulceration. Careful reconstruction of the clinical chronology…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.