{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T01:51:05Z","timestamp":1775872265300,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The causality between codeine and acute pancreatitis has not yet been fully deciphered in medical literature. Codeine-induced pancreatitis is a rare entity and the underlying mechanism of action mediated by codeine has not been completely elucidated. One plausible theory is that codeine increases the pressure of the sphincter of Oddi (SOD), which results in spasms and subsequently acute pancreatitis ensues. Codeine-induced pancreatitis has a predilection for patients with a previous surgical history of cholecystectomy. We herein present a case of a 74-year-old male patient presenting for severe epigastric pain radiating to the back after codeine intake for tension headache. His past surgical history was pertinent for a previous cholecystectomy that was done 3\u00a0years ago after which he reported no biliary-related symptoms. Upon detailed anamnesis, the patient reported that his pain was directly preceded by the intake of an analgesic medication for his tension headache. The painkiller consisted of 500\u00a0mg of acetaminophen, 8\u00a0mg of codeine and 30\u00a0mg of caffeine. CT scan of the abdomen and pelvis was performed and revealed a prominent pancreatic head with surrounding edema suggestive of acute pancreatitis. Codeine-induced pancreatitis is an uncommon entity. However, it has been documented in medical literature with a preponderance to patients who underwent previous cholecystectomy. Multiple pathophysiological elements come into play, such as decreased bile storage capacity and aberrant nervous wiring at the level of the SOD muscularity. These alterations result in increased SOD pressure and acute pancreatitis ensues. Nonetheless, this article should trigger future studies to further elucidate the causality between codeine and acute pancreatitis.<\/jats:p>","DOI":"10.1093\/omcr\/omag030","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:40Z","timestamp":1774287820000},"source":"Crossref","is-referenced-by-count":1,"title":["Codeine-induced pancreatitis in a previously Cholecystectomized patient: double the trouble"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1914-320X","authenticated-orcid":false,"given":"Karam","family":"Karam","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Houssein","family":"Chebbo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Saleh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Al Halabi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Attieh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Jalloul","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Hani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Fiani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Balamand , Rond Point Saloumeh - Dekouaneh - Lebanon P.O. Box: 55251 Sin El Fil, Dekweneh-Beirut 1003 ,","place":["Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026032313433887400_ref1","doi-asserted-by":"publisher","first-page":"e0231883","DOI":"10.1371\/journal.pone.0231883","article-title":"Drug induced pancreatitis: a systematic review of case reports to determine potential drug associations","volume":"15","author":"Wolfe","year":"2020","journal-title":"PLoS One"},{"key":"2026032313433887400_ref2","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1007\/s10620-021-06944-0","article-title":"Morphologic severity of acute pancreatitis on imaging is independently associated with opioid dose requirements in hospitalized patients","volume":"67","author":"Ashok","year":"2022","journal-title":"Dig Dis Sci"},{"key":"2026032313433887400_ref3","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1007\/s10620-019-05803-3","article-title":"Increased risk of acute pancreatitis with codeine use in patients with a history of cholecystectomy","volume":"65","author":"Kim","year":"2020","journal-title":"Dig Dis Sci"},{"key":"2026032313433887400_ref4","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.pan.2020.07.401","article-title":"Drug-induced acute pancreatitis: prevalence, causative agents, and outcomes","volume":"20","author":"Chadalavada","year":"2020","journal-title":"Pancreatology"},{"key":"2026032313433887400_ref5","doi-asserted-by":"publisher","first-page":"e00621","DOI":"10.14309\/ctg.0000000000000621","article-title":"Drug-induced acute pancreatitis: an evidence-based classification (revised)","volume":"14","author":"Saini","year":"2023","journal-title":"Clin Transl Gastroenterol"},{"key":"2026032313433887400_ref6","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/00006676-199610000-00017","article-title":"Acute pancreatitis induced by codeine-acetaminophen association: a case report with positive rechallenge","volume":"13","author":"Hastier","year":"1996","journal-title":"Pancreas"},{"key":"2026032313433887400_ref7","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1136\/gut.47.4.539","article-title":"Sphincter of Oddi dysfunction produces acute pancreatitis in the possum","volume":"47","author":"Chen","year":"2000","journal-title":"Gut"},{"key":"2026032313433887400_ref8","doi-asserted-by":"crossref","first-page":"6333","DOI":"10.3748\/wjg.v13.i47.6333","article-title":"Sphincter of Oddi dysfunction and pancreatitis","volume":"13","author":"McLoughlin","year":"2007","journal-title":"World J Gastroenterol"},{"key":"2026032313433887400_ref9","doi-asserted-by":"crossref","first-page":"3295","DOI":"10.1111\/j.1572-0241.2000.03213.x","article-title":"A new source of drug-induced acute pancreatitis: codeine","volume":"95","author":"Hastier","year":"2000","journal-title":"Am J Gastroenterology"},{"key":"2026032313433887400_ref10","doi-asserted-by":"publisher","first-page":"49","DOI":"10.4103\/jpgm.jpgm_531_24","article-title":"The bitter aftertaste: chronic pancreatitis and diabetes from codeine cough syrup","volume":"71","author":"Umarji","year":"2025","journal-title":"J Postgrad Med"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag030\/67483592\/omag030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/3\/omag030\/67483592\/omag030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:43:42Z","timestamp":1774287822000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omag030\/8537679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,23]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omag030","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"omag030"}}