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A 68-year-old woman presented to the emergency department with a 2-day history of epigastric pain, radiating to the back. A diagnosis of Crohn’s disease of the colon was made 6 months before the patient's current presentation, for which she was receiving oral 5-aminosalicylic acid. A colonoscopy performed 2 months before admission showed mucosal remission. On examination, the vital signs were normal and there was mild epigastric tenderness. Her serum amylase level was elevated to 581 U/L (normal range 28–100 U/L). Blood levels of calcium, triglycerides, aspartate aminotransferase, alanine aminotransferase, total bilirubin, alkaline phosphatase and IgG4 were normal. The cancer antigen (CA) 19-9 level was 40 U/mL (normal …
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.