Role of endoscopic ultrasound in identifying the causes of unexplained acute pancreatitis

Aims Acute pancreatitis remains of unclear etiology in approximately 10-30% of patients, even after comprehensive clinical, biochemical, and imaging evaluations. Endoscopic ultrasound (EUS) has emerged as a valuable tool, particularly effective for detailed examination of the biliopancreatic region, and may offer insights where other diagnostic methods fall short. The aim of our study is to assess the role of endoscopic ultrasound in identifying the causes of unexplained acute pancreatitis.

Methods We conducted a retrospective descriptive study involving 89 patients who underwent endoscopic ultrasound for unexplained acute pancreatitis between January 2009 and December 2023.

Results The mean age of our patients was 55 years (± 16.3), ranging from 17 to 89 years. The sex ratio (M/F) was 0.81, indicating a slight female predominance (55.1%). A history of prior acute pancreatitis was noted in 31.9% of cases, and 16.3% of patients had previously undergone cholecystectomy. The diagnostic performance of EUS in our study was 68%. Biliary causes were identified in 40.4% (n=36) of patients, with 19 of these patients undergoing complementary ERCP during the same anesthetic session. Tumor pathology was identified in 32.5% (n=30) of cases, and chronic pancreatitis was diagnosed in 22.4% (n=20) of patients. Additional findings included two cases of pancreas divisum, one case of sphincter of Oddi dysfunction, and one case of choledochocele. In 32% of cases, EUS results were normal, and no underlying cause was identified.

Conclusions Endoscopic ultrasound is currently an indispensable tool in the etiological investigation of unexplained acute pancreatitis. In our study, the diagnostic efficiency was around 68%.

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Artikel online veröffentlicht:
27. März 2025