Prospective evaluation of yield of endoscopic ultrasonography in the etiological diagnosis of 'idiopathic' acute pancreatitis

Autor: Narendra S. Choudhary, Rinkesh Kumar Bansal, Vinit Shah, Mukesh Nasa, Rajesh Puri, Ragesh Thandassery, Rajiv Ranjan Singh, Amit Bhasin, Sumit Bhatia, S. R. Misra, Suraj Bhagat, Chitranshu Vashishtha, Randhir Sud
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Journal of Digestive Endoscopy, Vol 07, Iss 04, Pp 133-136 (2016)
Druh dokumentu: article
ISSN: 0976-5042
0976-5050
DOI: 10.4103/0976-5042.195725
Popis: Background: Etiology of acute pancreatitis (AP) remains idiopathic in 30% of patients. Endoscopic ultrasound (EUS) has been shown to increase the diagnostic yield in patients with idiopathic AP (IAP). Aim: The aim of this study was to evaluate the role of EUS in achieving etiological diagnosis in patients with IAP. Materials and Methods: Consecutive 192 patients with IAP were evaluated prospectively with EUS over a period of 2 years. Patients who had no etiological diagnosis for AP after detailed history, clinical examination, laboratory investigations, and magnetic resonance cholangiopancreatography were included in the study. Results: The mean age of patients was 34.6 ± 12 and male:female ratio was 2.1:1. Of these, 135 patients had gallbladder intact (Group A) and 57 patients had undergone cholecystectomy (Group B). In Group A, EUS identified a possible cause in 79 (58.5%) patients; microlithiasis (n = 48), chronic pancreatitis (CP) (n = 23), common bile duct (CBD) and gallbladder stone (n = 3), pancreatic divisum (n = 3), small pancreatic tumor (n = 1), and anomalous pancreaticobiliary junction (n = 1). In Group B, EUS yielded diagnosis in 28 (49.1%) patients; CP (n = 22), ascariasis (n = 3), CBD stone (n = 2), and pancreatic divisum (n = 1). Overall EUS helped in achieving etiological diagnosis in 107 (55.1%) of patients with IAP. The presence of intact gallbladder showed a tendency for increased diagnostic yield (P = 0.06). Conclusion: EUS is a useful modality to establish the diagnosis in IAP and this technique should be incorporated in the evaluation of IAP.
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