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Gastrointestinal (GI) tract sarcoidosis is an uncommon form of sarcoidosis. The GI tract can be involved as an isolated disease as a part of systemic sarcoidosis. Clinical manifestations of esophageal, gastric, small bowel, colon, and appendicular sarcoidosis are discussed in this review. The differential diagnosis of GI sarcoidosis is extensive. Other granulomatous diseases of the GI tract, like tuberculosis, fungal infections, parasitic diseases, inflammatory bowel disease, and Whipple's disease, should be excluded before making the diagnosis of GI sarcoidosis. Corticosteroid therapy is effective in treatment of GI sarcoidosis. Surgical intervention may be necessary in patients with bowel obstruction, perforation, or massive hemorrhage.

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We report a case of fatal necrotizing pancreatitis associated with hydrochlorothiazide and lisinopril therapy. A 49-year-old man who presented with 2 days of abdominal pain and vomiting was found to have severe pancreatitis. The patient denied any alcohol use. In addition, abdominal ultrasound examinations showed no evidence of cholelithiasis or bile duct dilations. Review of his medication history with the family revealed that he was being treated with hydrochlorothiazide and lisinopril for hypertension. An exploratory laparotomy was performed and revealed no common bile duct stones. Unfortunately, the patient's hospital course was complicated with multiple organ failure, which resulted in death. To the best of our knowledge, there are only 3 other reported cases of hydrochlorothiazide-induced necrotizing pancreatitis reported in the literature.

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