Microlithiasis: an important cause of ‘idiopathic’ acute pancreatitis?

Abstract

Microlithiasis is the underlying cause in a significant proportion of patients with ‘idiopathic’ acute pancreatitis. The mechanism appears to be a relative deficiency of phosphatidylcholine in bile, with fast and extensive cholesterol crystallization as a result. Diagnosis of microlithiasis by microscopic detection of cholesterol crystals in bile is important and should lead to appropriate therapy (cholecystectomy, endoscopic sphincterotomy or ursodeoxycholic acid maintenance therapy).

Keywords

• Cholesterol
• crystallization
• MDR3 gene
• mucin
• sludge