Hyperamilasemia After Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) of Pancreatic Lesions: Incidence and Clinical Impact

Abstract

Endoscopic Ultrasonography Patterns of Autoimmune Pancreatitis Okabe Yoshinobu, Tsuruta Osamu, Suga Hideya, Saitou Fumihiko, Toyonaga Atsushi, Sata Michio Background and Aim: There have been only a few reports of endoscopic ultrasonography (EUS) investigation of autoimmune pancreatitis (AIP). The aim of this study was to clarify the EUS features of AIP. Patients and Methods: EUS was performed in seven patients with AIP and treated at our hospital between July 2002 and August 2005. AIP was diagnosed according to the criteria proposed by the Japan Pancreas Society and the criteria reported by Okazaki et al (GUT, 2002). All of the patients underwent blood chemistry, US, CT, ERCP, and EUS before therapy. EUS findings were investigated concerning the margin of the pancreas, pancreatic duct, and pancreatic parenchyma. Four patients were started on prednisolone 40 mg/day, two patients on 30 mg/day, and tapered by 10 mg in every two weeks. One patient did not agree with prednisolone administration. EUS was repeated in four patients after therapy, and changes in EUS findings were investigated. Results: The margin of the pancreas was irregular in six patients. In all patients, no pancreatic duct dilatation was noted, but there was found enlarged pancreas, and hyperechoic strands were imaged as a reticular pattern in the pancreatic parenchyma. In two patients who underwent EUS after therapy, the reticular pattern disappeared. In the rest of two patients, the reticular pattern disappeared in the pancreas tail but remained in the pancreas head. Conclusion: As EUS findings of AIP, swollen pancreas, a parenchymal reticular pattern, irregular margin, and no ductal dilatation were obtained. There were some similar reports in the early stage of chronic pancreatitis, but those EUS findings were changed after the steroid therapy in AIP.