Data regarding the role of endoscopic ultrasonography (EUS) in pediatric chronic/ recurrent pancreatitis (CP/RP) is limited. The aim of this study is to evaluate the role of EUS in the diagnosis and clinical observation of RP in childhood. Between September 2016 and September 2017 EUS findings of 17 patients with RP and 20 patients in a control group were evaluated retrospectively, and the findings were compared. The control group consisted of patients who underwent EUS for cholecystolithiasis but had no pancreatitis. The most common EUS finding was ≥3 mm hyperechoic strands in 15 (88.2%) of the patients. According to the Conventional criteria, 11 patients (64.7%) had pathological findings ≥3. No patient in this study fulfilled the Rosemont criteria for the definitive diagnosis of CP. In the comparison of the EUS findings of the pancreatitis cases to the control group, hyperechoic strands ≥3mm in the pancreatic parenchyma (p<0.001), lobularity (p=0.004), duct dilatation (p= 0.009) and hyperechoic duct margin (p<0.001) were determined to have statistically significant differences. In this study, hyperechoic line is the most common EUS finding of pancreatitis in childhood. The threshold number of EUS criteria for the diagnosis of CP in pediatric patients is unclear. However, in our opinion, the Conventional criteria are more suitable than the Rosemont criteria for the diagnosis of CP in childhood. Further studies are needed in this field.

AimDuodenal metastasis of testicular cancer is an uncommon condition in clinical practice. Here, we have reported a case of this nature.BackgroundTesticular cancers are among the most seen cancer types among young men. Metastasis of testicular cancer generally occurs through hematogenous and lymphatic drainage. Gastrointestinal (GI) metastasis of testicular cancer has been reported rarely.Case reportA duodenal mass was seen in esophagogastroduodenoscopic examination in a man who was admitted into hospital for medical treatment of resistant nausea and vomiting. He was previously diagnosed with testicular cancer. Computed tomography (CT) views were compatible with primary duodenal tumor. The duodenal mass was compatible with germ cell neoplasm metastasis. He received chemotherapy regime which includes cisplatin, paclitaxel, and ifosfamid. Nausea and vomiting symptoms decreased and metastatic mass and lymph nodes were regressed.ConclusionDuodenum metastasis of testicular cancer can be treated with a chemotherapy regimen, and patients can improve radiologically and symptomatically without the need of any surgery. Physicians should keep in mind that GI metastasis of testicular cancer may present with nausea and vomiting symptoms.How to cite this articleDuygulu ME, Kaymazli M, Goren I, Yildirim B, Sullu Y, Nural MS, Bektas A. Embryonal Testicular Cancer with Duodenal Metastasis: Could Nausea and Vomiting be Alarm Symptoms? Euroasian J Hepato-Gastroenterol 2016;6(2):198-201.

Purpose The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood. Methods Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Results Of the 41 patients included in the study 25 were girls (61.0%), mean age was 12.2±4.2 years. EUS was performed for biliary colic in 21 (51.2%), for recurrent pancreatitis in 12 (29.2%), for cholecystitis/cholangitis in 5 (12.2%), and for acute pancreatitis in 3 (7.4%) patients. EUS had a significant clinical effect in the decision of treatment and follow-up of 6/21 biliary colic cases, in diagnosis and follow-up of 6/12 recurrent pancreatitis cases, in decision-making and monitoring of invasive procedures (ERCP/surgery) of 3/5 acute cholecystitis/cholangitis and 2/3 of acute pancreatitis cases as well as in follow-up of the other cases. The effectiveness of EUS in determining direct treatment and invasive intervention was 43.9%. None of the patients had complications related to the EUS procedure. Conclusion Although current guidelines show that EUS can be used in pediatric patients, this is limited to a few published studies. In this study, it is shown that EUS is a safe method for the diagnosis, follow-up and treatment of common pancreatobiliary pathologies in childhood.