Severe acute pancreatitis as the presenting symptom of primary sclerosing cholangitis: treatment by endoscopic insertion of a biliary stent.

Primary sclerosing cholangitis is a chronic, fibrosing, inflammatory condition of unknown origin of extra and intrahepatic bile ducts. Recurrent cholangitis and jaundice are the most frequent clinical manifestation in symptomatic patients. We report a patient with primary sclerosing cholangitis presented with recurrent attacks of acute pancreatitis. Such a combination was not reported till now in the literature. The acute pancreatitis was probably due to reflux of bile and sludge into the pancreatic duct due to stricture of the distal part of a common bile and pancreatic ducts. Endoscopic insertion of a biliary stent managed to prevent jaundice and recurrent pancreatitis.