We describe the case of a patient who developed acute coronarysyndrome with hemodynamic instability in the presence of acutepancreatitis complicated by rupture of Wirsung duct. Primarypercutaneous coronary intervention of a totally occluded leftanterior descending artery was performed. We considered apathophysiology based on the occurrence of possible coronaryvasoconstriction induced by somatostatin, which was prescribedto this patient, and probable coronary atherosclerotic plaqueinstability mediated by elevated levels of C-reactive protein. Toour knowledge this is the first report of primary percutaneouscoronary intervention in a case of acute pancreatitis with ruptureof Wirsung duct.