Role of Endoscopic Ultrasound in Acute Pancreatitis Etiology Work-Up

Aims The aim is to assess the role of endoscopy ultrasound (EUS) in determining the etiology of acute pancreatitis.

Methods Retrospective, descriptive study, including patients who had EUS for unexplained acute pancreatitis (AP) after clinical biological and morphological investigations in acute phase, in hepato-gastroenterology department - Mohammed VI University hospital Oujda. We considered early phase during hospitalization for AP and delayed EUS at least a month after onset of AP.

Results 65 patients were included.

Mean age was 57.7, with sex ratio (F/M) 1.5.

32.3 % of pts had history of cholecystectomy.

Elevation of liver enzymes was noted in 66.2 % and cholestasis in 72.3 % during initial work-up.

The initial morphological assessment (ultrasound/CT +/- MRCP) showed a dilated common bile duct (CBD) without visible obstacle in 63 % of patients.

EUS was performed during the early phase of pancreatitis in 61 % of patients and 39 % had EUS within more than a month.

Among the patients who had CBD dilatation, 61 % of cases EUS visualized microlithiasis and 4,8 % a pancreatic tumor.

Among the patients who had non dilated CBD on initial imaging, 25 % had CBD microlithiasis in EUS.

In pts with non-lithiasis gallbladder and non-dilated CBD on the initial assessment EUS found microlithiasis in 15,3 % of cases.

In our study early EUS allowed etiological diagnosis of AP in 61 %, 90.5 % found microlithiasis and 9.5 % tumors

Delayed EUS allowed etiological diagnosis of AP in 38 % of pts were all diagnosed with microlithiasis.

Conclusions EUS performed in the early phase of acute pancreatitis detected a biliary etiology in 55.3 %, which allowed specific management and prevention of recurrence. In our series, early EUS detected pancreatic tumors in 5.8 % while other imaging techniques failed to confirm this diagnosis.

Delayed EUS confirmed etiology in 38 % of cases, all of them where of biliary etiology.

Citation Elmqaddem O, Nasiri M, Taiymi A et al. eP393 ROLE OF ENDOSCOPIC ULTRASOUND IN ACUTE PANCREATITIS ETIOLOGY WORK-UP. Endoscopy 2021; 53: S224.

Publication History

Article published online:
19 March 2021