Endoscopic ultrasound in idiopathic acute pancreatitis

Am J Gastroenterol. 2001 Mar;96(3):705-9. doi: 10.1111/j.1572-0241.2001.03609.x.


Objective: The aim of this study was to determine the utility of endoscopic ultrasound (EUS) in patients with unexplained acute pancreatitis, and whether endoscopic retrograde cholangiopancreatography (ERCP) is subsequently needed.

Methods: Subjects who underwent EUS for assessment of idiopathic acute pancreatitis were identified, their medical records were reviewed, and they were contacted for a follow-up telephone interview. EUS diagnosis was compared with the final diagnosis and outcome.

Results: EUS revealed a cause of pancreatitis in 21 of the 31 subjects (68%), including microlithiasis in five (16%), chronic pancreatitis in 14 (45%), pancreas divisum in two (6.5%), pancreatic cancer in one (3.2%), and was not diagnostic in 10 (32%). During a mean follow-up period of 16 months, diagnosis changed in four subjects (13%), and nine subjects (29%) had ERCP because of persistent symptoms or recurrent pancreatitis.

Conclusion: EUS, a less invasive test than ERCP, demonstrated an etiology in two-thirds of patients with idiopathic acute pancreatitis. Most patients did not require ERCP during the follow-up period. EUS can be an alternative to ERCP in patients with unexplained acute pancreatitis.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Alcohol Drinking
  • Cholangiopancreatography, Endoscopic Retrograde
  • Endosonography*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis / diagnosis
  • Pancreatitis / diagnostic imaging*