[Acute pancreatitis caused by a voluminous umbilical hernia. Case report]

A 65 year old woman, who had a giant umbilical hernia since more than 30 years, was admitted for a transitory cerebrovascular ischemia. During her stay, she presented an episode of acute pancreatitis localized in the head of the pancreas. All current causes of acute pancreatitis were ruled out, especially alcoholism and gallstones. Endoscopic retrograde cholangio-pancreatography performed in the patient lying on the left side demonstrated localization of the antrum and the duodenum with the head of the pancreas into the umbilical hernia. It seems clear that the giant umbilical hernia caused a progressive and intermittent passage of the head of the pancreas through chronic traction on the ligament of Treitz and acute pancreatitis by incarceration. At our knowledge, this mechanical cause of acute pancreatitis was not yet described in the literature.