Aberrant biliopancreatic duct: A probable cause of acute pancreatitis?

Abnormal biliopancreatic ducts are very uncommon in adults with the exception of those associated with abnormalities of either the pancreatic or the bile ducts. The case presented herein is unique in that a biliopancreatic connection occurred proximal to the papilla of Vater and the patient was symptomatic because of the aberrant connection. The surgical therapy consisted of cholecystectomy and ligation of the aberrant duct, with complete relief of severe, debilitating symptoms. This interesting clinical observation is discussed in the light of Opie's theory of biliary reflux into the pancreatic duct as a pathogenetic mechanism for acute pancreatitis.