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).