Crohn's Disease of the Duodenum Complicated by Pancreatitis and Common Bile Duct Obstruction

It is well known that Crohn's disease can involve the duodenum, but isolated secondary complications such as pancreatitis or common bile duct obstruction have only rarely been reported, and never in the same patient. Herein, we describe a patient with duodenal Crohn's disease and both pancreatitis and calculous common bile obstruction. This unusual constellation of findings was managed with percutaneous techniques in which transhepatic catheterization of the bile duct permitted balloon dilatation of the ampulla of Vater, as well as a duodenal stricture. These maneuvers resulted in passage of the biliary stone and relief of the patient's symptoms. The management of this patient may serve as a guide possibly to delay or even prevent surgical intervention in similar cases of benign enteric strictures.