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• W2017840928 abstract "Aims: Although Endoscopic Ultrasound (EUS) is often used as part of the evaluation of idiopathic acute pancreatitis, the success of the technique at identifying a disease etiology is unknown. We aimed to determine the rate at which EUS evaluation changed the diagnosis or management of patients with acute idiopathic pancreatitis. Methods: We retrospectively identified all patients sequentially referred to our medical center between March 1997 and July 2008 for EUS evaluation of acute or recurrent acute idiopathic pancreatitis. The etiology of acute pancreatitis was not known at the time of each EUS examination, despite an extensive outpatient work-up including cross-sectional imaging. All EUS exams were performed by expert endosonographers. Patient charts were abstracted by two reviewers for baseline patient characteristics, previous evaluation of pancreatitis, findings on EUS exam, and subsequent management. Results: Out of 3375 sequential EUS exams performed at our medical center, 110 patients underwent EUS specifically for evaluation of acute or recurrent acute idiopathic pancreatitis. The mean patient age was 51 years (range 10-88) and 63% were female. 71 (35%) patients had experienced multiple episodes of pancreatitis with a mean of four previous attacks. Nineteen patients (17%) had EUS findings which identified a disease etiology or changed patient management. Of these, 11 patients had findings of choledocholithiasis or microlithiasis, indicating a biliary source of pancreatitis. 3 patients (16%) had evidence of a dilated common bile duct without an intraluminal filling defect and underwent biliary sphincterotomy for presumed papillary stenosis. Additional findings included cystic neoplasms of the pancreas in two patients, islet cell tumor of the pancreas in one patient, inflammatory stricture of the pancreatic duct in one patient and one patient with pancreas divisum. 22 patients (20%) were diagnosed with chronic pancreatitis based on EUS criteria, although no etiology was determined in this group. None of these patients had been previously diagnosed with chronic pancreatitis. Conclusions: EUS examination determined an etiology of disease in 17% of patients undergoing evaluation for acute or recurrent acute idiopathic pancreatitis. Given the often significant challenges in identifying a cause of disease in this patient population, EUS does increase the diagnostic yield in some patients. All patients with recurrent pancreatitis should therefore undergo EUS evaluation before being labeled with idiopathic disease." @default.
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• W2017840928 date "2009-04-01" @default.
• W2017840928 modified "2023-09-26" @default.
• W2017840928 title "The Yield of Endoscopic Ultrasonography for Determining An Etiology in Patients with Idiopathic Acute Pancreatitis" @default.
• W2017840928 doi "https://doi.org/10.1016/j.gie.2009.03.630" @default.
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