A 62 old-year-male, with no medical history, was admitted for jaundice. The clinical examination noted cholestatic jaundice and scratching lesions. CT scan showed a pancreatic head cyst with upstream dilation of the common bile duct and intrahepatic duct. Biochemical examination showed acute cholangitis with total bilirubin at 16 mg/dL. Endoscopic ultrasound examination showed a cystic lesion at the head of the pancreas with multiple septation inducing upstream dilation of the common bile duct. FNA of the cyst showed clear liquid (dosage of ACE, glucose, and amylase requested). the patient presented 24 hours later with fever and tenderness of the abdomen. Re-EUS examination demonstrated a muddy aspect of the cyst suspecting an infection. we decided to perform a drainage with two double pigtail stents. the evolution was very favorable.