Successful cannulation of a difficult pancreatic duct using the uneven method.

Video 1Pancreatic cannulation via the uneven method.

Use of Peroral Pancreatoscopy in the Diagnosis of Elusive Intraductal Papillary Mucinous Neoplasm With High-Grade Dysplasia.

Intraductal papillary mucinous neoplasm (IPMN) is a premalignant lesion of the pancreas that can occasionally manifest as recurrent acute pancreatitis. In this report, we discuss a unique case of a 49-year-old woman who presented with recurrent acute pancreatitis of an unknown cause for several years. Workup using peroral pancreatoscopy eventually showed main-duct IPMN with high-grade dysplasia as the obscure cause of recurrent acute pancreatitis. This case report highlights the clinical course of main-duct IPMN and the evolving role of peroral pancreatoscopy in patients with recurrent acute pancreatitis.