Prospective Comparison of Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography in the Etiological Diagnosis of "Idiopathic" Acute Pancreatitis

Ortega, Alejandro; Gómez-Rodríguez, Rafael; Romero, M.; Fernández-Zapardiel, Soledad; Céspedes, María del Mar; Carrobles, J. L.

doi:10.1097/mpa.0b013e318201654a

Cited by 58 publications

(22 citation statements)

References 37 publications

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“…There are three studies which has directly compared EUS and MRCP in IAP[ 18 , 43 , 44 ]. All have found higher diagnostic yield of EUS particularly to exclude biliary causes.…”

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

“…The diagnostic yield of EUS was more than that of MRCP (51% vs 20%, P = 0.001). It was concluded that EUS should be performed for establishing a possible biliary aetiology in patients with intact gall bladder (GB)[ 44 ]. In a study of 40 patients with MRCP negative IAP by Rana et al[ 18 ], the diagnostic yield of EUS was 55%.…”

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

“…In two recent studies investigating the role of EUS/MRCP in IAP, these examinations were performed1 mo after initial AP when patients were eating normally. The explanation for delayed examination is that fasting is usually advised as initial treatment of AP which can induce GB sludge and, consequently, can result in a false-positive diagnosis of biliary AP if the examination is made early although this is not proven by studies[ 43 , 44 ].…”

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

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Role of endoscopic ultrasound in idiopathic pancreatitis

Somani¹,

Sunkara²,

Sharma³

2017

WJG

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Recurrent acute pancreatitis (RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. The initial evaluation fails to detect the cause of RAP in 10%-30% of patients, whose condition is classified as idiopathic RAP (IRAP). Idiopathic acute pancreatitis (IAP) is a diagnostic challenge for gastroenterologists. In view of associated morbidity and mortality, it is important to determine the aetiology of pancreatitis to provide early treatment and prevent recurrence. Endoscopic ultrasound (EUS) is an investigation of choice for imaging of pancreas and biliary tract. In view of high diagnostic accuracy and safety of EUS, a EUS based management strategy appears to be a reasonable approach for evaluation of patients with a single/recurrent idiopathic pancreatitis. The most common diagnoses by EUS in IAP is biliary tract disease. The present review aims to discuss the role of EUS in the clinical management and diagnosis of patients with IAP. It elaborates the diagnostic approach to IAP in relation to EUS and other different modalities. Controversial issues in IAP like when to perform EUS, whether to perform after first episode or recurrent episodes, comparison among different investigations and the latest evidence significance are detailed.

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“…There are three studies which has directly compared EUS and MRCP in IAP[ 18 , 43 , 44 ]. All have found higher diagnostic yield of EUS particularly to exclude biliary causes.…”

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

Section: What Is Idiopathic Pancreatitis?mentioning

confidence: 99%

See 1 more Smart Citation

Role of endoscopic ultrasound in idiopathic pancreatitis

Somani¹,

Sunkara²,

Sharma³

2017

WJG

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“…Of totally 222 unique studies that were retrieved by using the key word “EUS”, 122 were excluded duing to irrelevant topics, 61 were excluded as reviews and 32 were excluded as case reports. Eventually, 7 studies met the inclusion criteria and were therefore included in meta-analysis of EUS 16 19 26 27 28 29 30 ( Fig. 1B ).…”

Section: Resultsmentioning

confidence: 99%

The Accuracies of Diagnosing Pancreas Divisum by Magnetic Resonance Cholangiopancreatography and Endoscopic Ultrasound: A Systematic Review and Meta-analysis

Shen

Munker

Zhou

et al. 2016

Sci Rep

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Magnetic resonance cholangiopancreatography (MRCP), MRCP after secretin stimulation (S-MRCP) and endoscopic ultrasonography (EUS) are all selected to diagnose pancreas divisum. However, the accuracies of three diagnosis remain unclear. The aim is to address the diagnostic accuracies of MRCP, S-MRCP and EUS on pancreas divisum. We searched PubMed, MEDLINE and EMBASE databases from inception to January, 2015. Of the 536 citations retrieved, 16 studies were included. For MRCP diagnosis on pancreas divisum, the area under the hierarchical summary receiver-operating characteristic (HSROC) curve was 0.90 (95% confidence interval [CI] 0.87 to 0.92), and for S-MRCP and EUS, 0.99 (95% CI 0.97 to 0.99) and 0.97 (95% CI 0.96 to 0.98). Sensitivity and specificity for MRCP were 0.59 (95% CI 0.45 to 0.71) and 0.99 (95% CI 0.96 to 1.00); for S-MRCP, 0.83 (95% CI 0.66 to 0.92) and 0.99 (95% CI 0.96 to 1.00); for EUS, 0.85 (95% CI 0.67 to 0.94) and 0.97 (95% CI 0.90 to 0.99). Comprehensive comparison of three diagnostic techniques to pancreas divisum, S-MRCP was more reliable than MRCP and EUS on the effect of the diagnostic test.

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“…In a prospective comparison of EUS and MRCP for etiological diagnosis of idiopathic acute pancreatitis in 49 patients, MRCP could identify PD in 4 patients, whereas EUS could diagnose PD in only 1 patient. [ 20 ] However, the low detection rate of PD by EUS may be due to operator-dependent imaging. In a large series of patients with PD, secretin-stimulated EUS (S-EUS) showed dilation of the dorsal duct by 1 mm or more following intravenous secretin.…”

Section: Introductionmentioning

confidence: 99%

Imaging of pancreas divisum by linear-array endoscopic ultrasonography

Sharma

Pathak

Rameshbabu³

et al. 2016

Endosc Ultrasound

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Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. Endoscopic ultrasound (EUS) is often performed to evaluate idiopathic pancreatitis and has been shown to have high accuracy in diagnosis of PD. The different techniques to identify PD by linear EUS have been described differently by different authors. If EUS is done with a proper technique it can be a valuable tool in the diagnosis of PD. The anatomical and technical background of different signs has not been described so far. This article summarizes the different techniques of imaging of pancreatic duct in a suspected case of PD and gives a technical explanation of various signs. The common signs seen during evaluation of pancreatic duct in PD are stack sign of linear EUS, crossed duct sign on linear EUS, the dominant duct and ventral dorsal duct (VD) transition. Few other signs are described which include duct above duct, short ventral duct /absent ventral duct, separate opening of ducts with no communication, separate opening of ducts with filamentous communication, stacking of duct of Santorini and indirect signs like santorinecele. The principles of the sign have been explained on an anatomical basis and the techniques and the principles described in the review will be helpful in technical evaluation of PD during EUS.

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Prospective Comparison of Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography in the Etiological Diagnosis of "Idiopathic" Acute Pancreatitis

Abstract: Endoscopic ultrasonography and MRCP are useful techniques in the etiological diagnosis of acute pancreatitis of nonestablished cause. Endoscopic ultrasonography should be preferred for establishing a possible biliary etiology in patients who have not had a cholecystectomy.

Cited by 58 publications

References 37 publications

Role of endoscopic ultrasound in idiopathic pancreatitis

Role of endoscopic ultrasound in idiopathic pancreatitis

The Accuracies of Diagnosing Pancreas Divisum by Magnetic Resonance Cholangiopancreatography and Endoscopic Ultrasound: A Systematic Review and Meta-analysis

Imaging of pancreas divisum by linear-array endoscopic ultrasonography

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