Autoimmune pancreatitis is a chronic inflammation of the pancreas due to aetiopathogenic mechanisms of autoimmunity. There are no established definitive diagnostic criteria although histological, analytical, and radiological characteristics enable us to identify this entity in the differential diagnosis with chronic alcoholic pancreatitis and cancer of the pancreas.^1–3 Nevertheless, this is not always possible, and the patient undergoes surgery with suspected cancer of the pancreas. Lymphoplasmacytic infiltration and the autoimmune response do not only affect the pancreas but can occasionally involve the retropancreatic and extrapancreatic biliary system. The relationship between the appearance of sclerosing cholangitis in patients with pancreatic pseudotumour due to autoimmune pancreatitis has even been considered the result of a systemic fibroinflammatory response.^1,4 We present the exceptional case of a patient who, after a cephalic duodenopancreatectomy due to pancreatic pseudotumour, in lymphoplasmacytic pancreatitis, presented with a clinical-radiological picture of post-surgical sclerosing cholangitis, which resolved after therapy with steroids. In common with Kamisawa and colleagues,⁴ we consider autoimmune pancreatitis a lesion more as part of a condition with multifocal fibrosclerosis and we believe that this sclerosing cholangitis is an additional manifestation of an autoimmune systemic condition, possibly stimulated by surgery.

A 78 year old male patient was admitted to our service for obstructive jaundice …