Endoscopy 2003; 35(6): 534-537
DOI: 10.1055/s-2003-39658
Case Report

© Georg Thieme Verlag Stuttgart · New York

Pancreatic Intraductal Ultrasonography (IDUS) Allows Early Diagnosis of Pancreatic Carcinoma in Situ: A Case Report

Q.  Ly 1 , M.  Rünzi 2 , J.  Menzel 3 , K.  U.  Rehbehn 2 , A.  Zimmermann 4 , M.  W.  Büchler 1 , H.  Friess 1
  • 1Dept. of General Surgery, University of Heidelberg, Germany, and Dept. of Visceral and Transplantation Surgery, Inselspital, University of Berne, Switzerland
  • 2Dept. of Gastroenterology and Metabolism, Essen South Hospital, Catholic Hospital Essen, Germany
  • 3Dept. of Medicine B, University of Münster, Münster, Germany
  • 4Institute of Pathology, Inselspital, University of Berne, Switzerland
Further Information

Publication History

Submitted 9 February 2002

Accepted after Revision 11 October 2002

Publication Date:
03 June 2003 (online)

A 66-year-old woman was admitted with diarrhea, weight loss, slight recurrent abdominal pain, and raised serum amylase and lipase. Lactose intolerance was diagnosed, and treatment was begun. The symptoms diminished. However, slight back pain and elevated serum amylase and lipase levels persisted. A pancreatic tumor was then suspected. Ultrasound, spiral computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP) examinations were inconclusive. Endoscopic retrograde cholangiopancreatography (ERCP) showed a slight narrowing of the pancreatic duct within the pancreatic body, and endoscopic ultrasound (EUS) revealed a 10 mm intrapancreatic lesion. Finally, intraductal ultrasonography (IDUS) reliably identified a small pancreatic tumor. The tumor was resected, and histology confirmed a well-differentiated adenocarcinoma in situ (UICC stage 0, TisN0M0). This case shows that using high-resolution imaging techniques such as EUS plus IDUS, small malignant pancreatic lesions can be detected at an early stage, when curative action is possible.


H. Friess, M.D.

Dept. of General Surgery, University of Heidelberg

Im Neuenheimer Feld 110 · 69120 Heidelberg · Germany

Fax: + 49-6221-56-6903

Email: helmut_friess@med.uni-heidelberg.de