This patient demonstrates many of the reported abdominal manifestations of cystic fibrosis. These include fatty replacement of the pancreatic parenchyma, the development of multiple macroscopic cysts (pancreatic cystosis), and gallstones. Layering cyst contents, in this case, is not typical but has been reported in pancreatic cystosis 1.
In this case, the patient's symptoms may have been secondary to intra-hepatic choledocholithiasis, and the presence of pancreatic cystosis was likely incidental.
The case was provided courtesy of Dr. Brian Gibney, Mater Misericordiae University Hospital, Dublin.