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Role of endoscopic ultrasound in idiopathic acute pancreatitis with negative ultrasound, computed tomography, and magnetic resonance cholangiopancreatography.

Rana SS, Bhasin DK, Rao C, Singh K - Ann Gastroenterol (2012)

Bottom Line: No underlying cause could be found in 18 (45%) patients.Half of the cases without identified etiology already had an underlying CP.EUS is a very important tool in evaluating IAP especially after an initial negative diagnostic workup.

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

ABSTRACT

Background: Idiopathic acute pancreatitis (IAP) is a diagnostic challenge. Finding a treatable cause after appropriate investigation may help to prevent recurrent pancreatitis and further management. The aim of our study was to retrospectively report our experience with endoscopic ultrasound (EUS) in investigating patients with IAP.

Methods: Forty patients (26 males; age range: 17-72 years) of IAP with no underlying cause identified on transabdominal ultrasound, computed tomography and magnetic resonance cholangiopancreatography were studied. In 23 patients (57.5%), it was the first attack of acute pancreatitis whereas in 17 patients (42.5%) there was at least one previous attack of documented acute pancreatitis. EUS examination was done using a radial echoendoscope.

Results: Twenty (50%) of the patients had biliary tract disease (cholelithiasis in 3, gallbladder sludge in 13, choledocholithiasis in 1 and common bile duct sludge in 3 patients). One each had an 8 mm tumor in the head of pancreas and pancreas divisum. No underlying cause could be found in 18 (45%) patients. Nine patients had features of chronic pancreatitis (CP) and the remaining had a normal pancreas.

Conclusions: Occult biliary pathology is the predominant cause of IAP. Half of the cases without identified etiology already had an underlying CP. EUS is a very important tool in evaluating IAP especially after an initial negative diagnostic workup.

No MeSH data available.


Related in: MedlinePlus

Endoscopic ultrasound showing changes of chronic pancreatitis
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Figure 4: Endoscopic ultrasound showing changes of chronic pancreatitis

Mentions: Of these 18 patients, 9 patients had EUS features of chronic pancreatitis (Fig. 4) and on follow up they had recurrent episodes of abdominal pain without elevation of pancreatic enzymes. The follow-up EUS reconfirmed the initial findings of chronic pancreatitis and 2/9 (22.2%) patients developed parenchymal calcification on follow up. The remaining 9 patients with normal pancreas subsequently remained well on a follow-up period of 5-36 months.


Role of endoscopic ultrasound in idiopathic acute pancreatitis with negative ultrasound, computed tomography, and magnetic resonance cholangiopancreatography.

Rana SS, Bhasin DK, Rao C, Singh K - Ann Gastroenterol (2012)

Endoscopic ultrasound showing changes of chronic pancreatitis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959389&req=5

Figure 4: Endoscopic ultrasound showing changes of chronic pancreatitis
Mentions: Of these 18 patients, 9 patients had EUS features of chronic pancreatitis (Fig. 4) and on follow up they had recurrent episodes of abdominal pain without elevation of pancreatic enzymes. The follow-up EUS reconfirmed the initial findings of chronic pancreatitis and 2/9 (22.2%) patients developed parenchymal calcification on follow up. The remaining 9 patients with normal pancreas subsequently remained well on a follow-up period of 5-36 months.

Bottom Line: No underlying cause could be found in 18 (45%) patients.Half of the cases without identified etiology already had an underlying CP.EUS is a very important tool in evaluating IAP especially after an initial negative diagnostic workup.

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

ABSTRACT

Background: Idiopathic acute pancreatitis (IAP) is a diagnostic challenge. Finding a treatable cause after appropriate investigation may help to prevent recurrent pancreatitis and further management. The aim of our study was to retrospectively report our experience with endoscopic ultrasound (EUS) in investigating patients with IAP.

Methods: Forty patients (26 males; age range: 17-72 years) of IAP with no underlying cause identified on transabdominal ultrasound, computed tomography and magnetic resonance cholangiopancreatography were studied. In 23 patients (57.5%), it was the first attack of acute pancreatitis whereas in 17 patients (42.5%) there was at least one previous attack of documented acute pancreatitis. EUS examination was done using a radial echoendoscope.

Results: Twenty (50%) of the patients had biliary tract disease (cholelithiasis in 3, gallbladder sludge in 13, choledocholithiasis in 1 and common bile duct sludge in 3 patients). One each had an 8 mm tumor in the head of pancreas and pancreas divisum. No underlying cause could be found in 18 (45%) patients. Nine patients had features of chronic pancreatitis (CP) and the remaining had a normal pancreas.

Conclusions: Occult biliary pathology is the predominant cause of IAP. Half of the cases without identified etiology already had an underlying CP. EUS is a very important tool in evaluating IAP especially after an initial negative diagnostic workup.

No MeSH data available.


Related in: MedlinePlus