Evaluation of the relationship between chronic pancreatitis and endoscopic ultrasonography in pediatric patients

Abstract

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.