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A case of pancreatic abscess with pancreaticobiliary fistula manifesting as obstructive jaundice of occult etiology is presented. Diagnosis was made preoperatively by skinny needle percutaneous transhepatic cholangiography. In addition, a communication between the biliary tree and the pancreatic abscess cavity was demonstrated in the absence of previous biliary surgery or primary biliary tract disease. We feel this is the procedure of choice for emergency visualization of the biliary tree in a jaundiced patient where a surgically approachable lesion is suspected.
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