The case of a 67-year-old patient with acute pancreatitis and consecutive development of a pancreatic pseudocyst is reported. He originally suffered from a gallstone disease which was treated by extracorporeal shock wave lithotripsy. One day after treatment he developed acute pancreatitis. Endoscopic retrograde cholangiopancraticography showed the duct abnormality of pancrease divisum. This excludes obstruction of pancreatic outflow by a passing gallstone as a possible cause of acute pancreatitis. Therefore, extracorporeal shock wave lithotripsy must be the underlying cause of acute pancreatitis. To our knowledge, this is only the second report on acute pancreatitis due to shock wave lithotripsy.

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