Computed tomographic abnormalities of the pancreas in eating disorders: A report of two cases with normal laparotomy

Abstract

We report two patients with abdominal pain and weight loss who underwent laparotomy on the basis of computed tomographic abnormalities of the pancreas suggestive of neoplastic disease. The operations failed to reveal any gross or microscopic pathology in both instances, including one in whom a partial resection was performed. An eating disorder was belatedly diagnosed in each case. Because radiological abnormalities of the pancreas are not uncommon in patients with eating disorders, we suggest that this diagnosis be entertained before any interventional procedures are undertaken on a patient with a potential eating disorder having abnormal densities on pancreatic imaging.

Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract

“…Two cases have been reported where patients with bulimia nervosa were admitted to hospital with pancreatic abnormalities. The attending physicians assumed that the patients had pancreatic carcinomas because the clinical features supported this diagnosis (71). A computed tomographic scan showed enlargement of the pancreas in both patients.…”

“…A computed tomographic scan showed enlargement of the pancreas in both patients. It was later discovered that the diagnosis of bulimia nervosa had been missed in both cases and that acute pancreatitis likely resulted from a large binge followed by several days of fasting, or that misuse of laxatives or diuretics may have caused druginduced pancreatitis (71). These cases illustrate that bulimia is difficult to detect.…”

Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract

“…Two cases have been reported where patients with bulimia nervosa were admitted to hospital with pancreatic abnormalities. The attending physicians assumed that the patients had pancreatic carcinomas because the clinical features supported this diagnosis (71). A computed tomographic scan showed enlargement of the pancreas in both patients.…”

“…A computed tomographic scan showed enlargement of the pancreas in both patients. It was later discovered that the diagnosis of bulimia nervosa had been missed in both cases and that acute pancreatitis likely resulted from a large binge followed by several days of fasting, or that misuse of laxatives or diuretics may have caused druginduced pancreatitis (71). These cases illustrate that bulimia is difficult to detect.…”

Assessment of physical status of children and adolescents with eating disorders and obesity.

“…Pancreatic abnormalities may be associated with eating disorders (Gilinsky, Humphries, Fried, & McClain, 1988;Keane, Fennell, & Tomkin, 1978;McClain, Humphries, Hill, & Nickl, 1993). Acute pancreatitis (inflamation of the pancreas) has been reported sometimes in relation to the ASSESSMENT OF PHYSlCAL STATUS I77 refeeding process of anorexic patients.…”

A role for Helicobacter pylori in the gastrointestinal complaints of eating disorder patients?

“…Gastrointestinal complications are common and varied in patients with the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN). These patients frequently present with complaints of nausea, bloating, burning sensations in the stomach, uncomfortable fullness, and diarrhea alternating with constipation (Hill et al, 1996;McClain, Humphries, Hill, & Nickl, 1993;Gilinsky, Humphries, Fried, & McClain, 1988). Many of these symptoms can be indistinguishable from gastritis and peptic ulcer disease.…”

Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract

“…Two cases have been reported where patients with bulimia nervosa were admitted to hospital with pancreatic abnormalities. The attending physicians assumed that the patients had pancreatic carcinomas because the clinical features supported this diagnosis (71). A computed tomographic scan showed enlargement of the pancreas in both patients.…”

“…A computed tomographic scan showed enlargement of the pancreas in both patients. It was later discovered that the diagnosis of bulimia nervosa had been missed in both cases and that acute pancreatitis likely resulted from a large binge followed by several days of fasting, or that misuse of laxatives or diuretics may have caused druginduced pancreatitis (71). These cases illustrate that bulimia is difficult to detect.…”

Assessment of physical status of children and adolescents with eating disorders and obesity.

“…Pancreatic abnormalities may be associated with eating disorders (Gilinsky, Humphries, Fried, & McClain, 1988;Keane, Fennell, & Tomkin, 1978;McClain, Humphries, Hill, & Nickl, 1993). Acute pancreatitis (inflamation of the pancreas) has been reported sometimes in relation to the ASSESSMENT OF PHYSlCAL STATUS I77 refeeding process of anorexic patients.…”

A role for Helicobacter pylori in the gastrointestinal complaints of eating disorder patients?

“…Gastrointestinal complications are common and varied in patients with the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN). These patients frequently present with complaints of nausea, bloating, burning sensations in the stomach, uncomfortable fullness, and diarrhea alternating with constipation (Hill et al, 1996;McClain, Humphries, Hill, & Nickl, 1993;Gilinsky, Humphries, Fried, & McClain, 1988). Many of these symptoms can be indistinguishable from gastritis and peptic ulcer disease.…”

Physiological Effects of Bulimia Nervosa on the Gastrointestinal Tract

“…Two cases have been reported where patients with bulimia nervosa were admitted to hospital with pancreatic abnormalities. The attending physicians assumed that the patients had pancreatic carcinomas because the clinical features supported this diagnosis (71). A computed tomographic scan showed enlargement of the pancreas in both patients.…”

“…A computed tomographic scan showed enlargement of the pancreas in both patients. It was later discovered that the diagnosis of bulimia nervosa had been missed in both cases and that acute pancreatitis likely resulted from a large binge followed by several days of fasting, or that misuse of laxatives or diuretics may have caused druginduced pancreatitis (71). These cases illustrate that bulimia is difficult to detect.…”

Assessment of physical status of children and adolescents with eating disorders and obesity.

“…Pancreatic abnormalities may be associated with eating disorders (Gilinsky, Humphries, Fried, & McClain, 1988;Keane, Fennell, & Tomkin, 1978;McClain, Humphries, Hill, & Nickl, 1993). Acute pancreatitis (inflamation of the pancreas) has been reported sometimes in relation to the ASSESSMENT OF PHYSlCAL STATUS I77 refeeding process of anorexic patients.…”

A role for Helicobacter pylori in the gastrointestinal complaints of eating disorder patients?

“…Gastrointestinal complications are common and varied in patients with the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN). These patients frequently present with complaints of nausea, bloating, burning sensations in the stomach, uncomfortable fullness, and diarrhea alternating with constipation (Hill et al, 1996;McClain, Humphries, Hill, & Nickl, 1993;Gilinsky, Humphries, Fried, & McClain, 1988). Many of these symptoms can be indistinguishable from gastritis and peptic ulcer disease.…”