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We present a patient with acute pancreatitis that was specially persistent from a biochemical viewpoint, derived from a duodenal sarcomatous tumor of immunoblastic type that narrowed the second duodenal segment for a length of about 8 centimeters. We discuss the possible role of tumoral neoformations in the production of pancreatitis due to increased intraluminal pressure distal to the Vater ampulla, or to occlusion of the Oddi sphincter or the Wirsung duct. We review the existent literature.

The understanding of the causes for hyperamylasemia is of great importance when focusing on the differential diagnosis of acute pancreatitis. Among the causes for hyperamylasemia, special interest is given to macroamylasemia not only because it is poorly understood, but also because we are lacking national studies. In this disorder, the amyl binds to another serum substance, varying from one patient to another, and forms a macromolecular complex. The biochemical characteristics of clinical interest as well as its prevalence are discussed. Its etiopathogenesis and clinical implications are unknown, requiring different methods for its detection that will give better efficacy and reproducibility.