Recurrent acute pancreatitis is often caused by excessive alcohol intake and bile stones. Patients suffering from more than one episode of acute pancreatitis are diagnosed with recurrent acute pancreatitis. The etiology of recurrent acute pancreatitis is known in 70 to 90% of patients after evaluation incorporating history taking, physical examination, routine laboratory assessment, and transabdominal ultrasonography or CT scan. However, the etiology of 10 to 30% of patients with recurrent acute pancreatitis remains undetermined. Further more sensitive evaluation is often performed, such as ERCP, ultrasound endoscopy, or MRCP, in order to determine the cause for recurrent acute pancreatitis. These tests are usually able to diagnose microlithiasis, sphincter oddi dysfunction, or pancreatic division,3-4'5-6>7.Medina- Perez M, Garcia Ferris G, Caballow Gomes J, Hospital de la Merced, and Ossuna Sevilla reported a rare case on a 33-year old woman with recurrent acute pancreatitis related with an anatomical abnormality in the form of a duplicate duodenal ampulla with multiple stones2 Even though several researches were able to detect microlithiasis in less than 10% of all patients with recurrent acute pancreatitis, most of them found microlithiasis in approximately two thirds of the patients.3 |