[Usefulness of microscopic study of the duodenal bile in the diagnosis of pancreatitis of unknown cause].

In spite of the numerous causes of acute pancreatitis reported, among which the most frequent are biliary lithiasis and alcoholism, the etiology remains obscure in many patients, being termed idiopathic in these cases. The presence of microcalculi in the bile juice has been described as a cause of some pancreatitis initially labeled as of unknown cause. We studied the duodenal bile juice of 22 patients who were admitted on various occasions for acute pancreatitis, in whom the etiology could not be clarified in spite of the anamnesis and explorations. Microscopic study of the bile juice showed the presence of microlithiasis in 36.3% of cases. We conclude that microscopic study of the bile juice is a risk-free technique that should be included systematically in the investigation of the etiology of idiopathic pancreatitis.