Commonly identified mutations in the CFTR, SPINK1 and PRISS1, CTRC genes have been associated with pancreatitis and should be evaluated in patients younger than 35 with RAP.[13,14] In particular mutations in PRISS1 is a well characterized autosomal dominant cause of hereditary RAP.[14] Finally, evaluation of RAP should include assessment of unusual etiologies such as ampullar neoplasms and anatomic variants like type III choledochal cyst, and anomalous pancreaticobiliary junction.[13,14]. The gene discussed is SPINK1; the disease is pancreatitis.