A 67-year-old man came to our hospital with a chief complaint of jaundice and itching. Abdominal ultrasonography and computed tomography showed cystic tumor of the pancreas head and dilatation of the bile and pancreatic ducts. After we diagnosed obstructive jaundice, we performed percutanous transhepatic cholangio-drainage. Magnetic resonance cholangiopancreatography and percutanous transhepatic cholangiography showed fistulous communication with pancreatic duct and common bile duct. We performed percutanous transhepatic cholangioscope, in result we found mucinous ductal ectasia into the through pancreatico-cholangio-fistula. Under the diagnosis of intraductal papillary mucinous tumor (adenoma) , the patient was treated by pancreatico-duodenectomy. Histological examination of the specimen showed invasive carcinoma drived from IPMT, accompanied by invasion into CBD. We reported the case of IPMT with obstructive jaundice due to mucus through pancreatico-cholangio-fistula.
