Usefulness of endoscopic ultrasonography in patients with “idiopathic” acute pancreatitis

Recurrent acute pancreatitis: an approach to diagnosis and management

“…73 EUS correctly established the cause in 92% of patients compared to the final diagnosis at surgery. Another study, which looked at the diagnostic utility of ERCP with SOM, bile microscopy, and EUS in patients with idiopathic and RAP showed that, EUS was useful in diagnosing biliary diseases and tumours, and was able to identify 9 patients with CP, which ERCP could not identify.…”

Comparison of Endoscopic Ultrasound (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP) in Diagnosing Cholelithiasis in Acute Biliary Pancreatitis Patients

“…EUS allows us to visualize small lithiasis and small quantities of biliary sludge not visible with other imaging technique, including MRCP. 14 The results from this prospective study is not different from recent reviews about EUS, which explained that in selected patients with acute pancreatitis, EUS can be safely replace diagnostic ERCP and select patients eligible for therapeutic ERCP with a higher success rate. In other study, EUS may prevent ERCP in 71% of patients with acute pancreatitis and offers a complication-free alternative.…”

Endoscopic ultrasonography for evaluating patients with recurrent pancreatitis

“…EUS identified an abnormality in 80% of these patients, and 62% of them had biliary tract pathology such as stones, sludge, or microlithiasis. Compared to the final diagnosis at surgery, ERCP, bile crystal analysis, or medical followup, EUS correctly established the causes of pancreatitis in 92% of patients [13] ( Figure 4). Microlithiasis may lead to pancreatitis through several mechanisms: transient impaction of small stones at the papilla, obstructing the pancreatic duct, or the repeated passage of stones (which may lead to papillary stenosis or SOD, both of which are associated with pancreatitis) [14] .…”

“…Microlithiasis may lead to pancreatitis through several mechanisms: transient impaction of small stones at the papilla, obstructing the pancreatic duct, or the repeated passage of stones (which may lead to papillary stenosis or SOD, both of which are associated with pancreatitis) [14] . Surgical or endoscopic treatment of occult microlithiasis significantly reduces the recurrent episodes of acute pancreatitis compared with untreated patients [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Three recent studies maintain that EUS should replace ERCP as the first procedure in patients with mild to moderate acute pancreatitis to avoid unnecessary ERCP and thus reduce ERCP-induced morbidity [22][23][24] .…”