Letters to the Editor 375 Annals of Gastroenterology 26 A rare cause of biliary obstruction and pancreatitis

The prevalence of duodenal diverticula varies consider-ably in the literature, between 3-24 % [1,2]. They are acquired extraluminal outpouchings of the mucosal wall through the muscularis propria and their incidence increases with age. While most duodenal diverticula do not cause major symptoms, they are increasingly recognized as causes of pancreaticobiliary disease. Food bezoar in a juxtapapillary duodenal diverticulum (JPDD) causing pancreaticobiliary obstruction is rare, with the first of such case reported in 1977 [3]. We present a case of food bezoar in JPDD causing pancreatitis, severe pancreaticobiliary duct obstruction and dilation--mimicking as neoplasm-- that was successfully diagnosed and treated endoscopically. A 60-year-old female presented with two months of right 376 Letters to the Edito