Pancreatic pseudocyst associated with eating disorder

Area of Science:

• Gastroenterology
• Endocrinology
• Psychiatry

Background:

• Eating disorders can present with complex medical complications beyond typical nutritional deficiencies.
• Hyperamylasemia, often associated with pancreatic conditions, can also originate from salivary glands.
• Salivary gland involvement in eating disorders, such as parotid enlargement, is a known but less commonly discussed manifestation.

Observation:

• A 40-year-old woman with a 9-year history of eating disorder presented with abdominal pain, diarrhea, and nausea.
• She exhibited bilateral parotid enlargement and markedly elevated serum amylase levels, primarily due to salivary isoamylase.
• Following symptom resolution and reintroduction of oral intake, she developed abdominal pain, elevated pancreatic enzymes, and a large pancreatic pseudocyst.

Findings:

• The patient was diagnosed with parotid enlargement and acute exacerbation of chronic pancreatitis.
• A huge pancreatic pseudocyst was identified and successfully managed with percutaneous drainage.
• Endoscopic retrograde cholangiopancreatography revealed irregularities in the pancreatic duct, suggesting chronic changes.

Implications:

• This case underscores the importance of considering salivary gland hyperamylasemia in patients with eating disorders presenting with gastrointestinal symptoms.
• It highlights a rare but serious complication of pancreatitis and pancreatic pseudocyst formation linked to eating disorders.
• Further research may be warranted to understand the pathophysiology and management strategies for this specific patient population.