Role of Endoscopic Ultrasonography in Exploring the Etiology of Acute Biliary Pancreatitis with Negative MRCP Results

Abstract

Objectives: To explore the role of endoscopic ultrasonography(EUS) in exploring the etiology of acute biliary pancreatitis with negative MRCP results. Methods Acute biliary pancreatitis were defined as typical pain of acute pancreatitis, serum amylase over 3 times of upper normal limit, with pancreatic parenchyma changes or surrounding exudates confirmed by CT or MRI, serum ALT over 3 times of upper normal limit. Twenty seven patients consistent with above features were enrolled from Jun 1st to Dec 31, 2006 in Changhai hospital. All the 27 patients were examined by MRCP within 7 days after the attack of the diseases with negative results. EUS were carried out within 10 days after the attack of the diseases. Results Among the 27 patients, abnormality associated with acute pancreatitis were found in 11 cases, while other 16 patients with negative EUS results. Among the 11 abnormalities, seven were biliary stones with size varing from 2 mm to 5.2 mm, two were biliary sludge, one was ampullary adenocarcina with size of 6 mm × 5 mm confirmed by subsequent EUS-FNA, one was pancreatic head duct dilated slightly with 5 mm in width with unknown causes. Conclusions The results suggest that EUS is helpful to find the etiology of acute biliary pancreatitis with negative MRCP results.