Extensive Calcific Chronic Pancreatitis Developing Within Three Years After Acute Pancreatitis and Incidentally...

Pancreatic calcification is a hallmark structural change of chronic pancreatitis. However, few reports have described extensive diffuse pancreatic calcification that develops within a relatively short period after acute pancreatitis and is incidentally detected during urological evaluations. We report the case of a 34-year-old man who presented with urinary frequency, gross hematuria, and the passage of sand-like material in his urine. He had smoked five cigarettes per day and consumed alcohol on approximately 10 occasions per month since the age of 29 years, when abnormal liver function was noted on routine tests, and he developed acute pancreatitis at the age of 31 years. Computed tomography (CT) and magnetic resonance cholangiopancreatography performed at that time revealed no pancreatic calcifications. At the current presentation, he was diagnosed with acute bacterial prostatitis, and a urine culture yielded Escherichia coli. A kidneys, ureters, and bladder (KUB) radiograph performed to evaluate suspected urolithiasis incidentally revealed multiple calcified densities in the pancreatic region. Moreover, noncontrast CT demonstrated extensive diffuse calcifications involving the entire pancreas, with mild pancreatic enlargement. Serum calcium, IgG4, intact parathyroid hormone, and HbA1c levels were within the normal ranges, suggesting that alcohol consumption and smoking were the most likely etiological factors. This case suggests that extensive calcific chronic pancreatitis can develop within a relatively short period following acute pancreatitis. Clinicians evaluating KUB radiographs and CTs performed for urological indications should systematically check for clinically significant incidental findings outside the urinary tract.