Bile pancreatitis.

Bile pancreatitis was studied both macropathologically and histopathologically in cases with an abnormal pancreatic choledochoductal junction, in which free communication between the pancreatic duct and the common bile duct occurred. The intraductal pressure of the pancreatic duct is normally higher than that of the bile duct, therefore, the pancreatic juice flows into the bile duct. In this study, we found squamous carcinoma cells from an adeno-squamous cell carcinoma of the gall-bladder in the main pancreatic duct. Hence, the possibility of bile reflux into the pancreatic duct was also considered. Outstanding findings, such as degeneration and disappearance of the pancreatic ductal epithelium, intraluminal aggregation of bacilli, and diffuse interlobular fibrosis were found in four of 15 cases with an abnormal junction. Similar ductal alterations and diffuse fibrosis were found neither in the controls nor in the remaining 11 cases. Therefore, it appears that pancreatic disorders due to the reflux of bile occurs in the presence of bacteria.