[Endosonography in chronic pancreatitis. A comparative study of endoscopic retrograde pancreatography and endoscopic sonography].
EUS and ERP were performed in 114 patients. 94 patients (32 women, 62 men; mean age 53 years; range 29-78 years) had inflammatory pancreatic disease while 20 patients (6 women, 14 men; mean age 54 years; range 28-78 years) without disease of the pancreas served as controls. ERP-findings served as the gold standard and were classified into stages I-III according to the Cambridge classification. On ERP 51 patients had duct changes typical of chronic pancreatitis (CP). Control cases always displayed a homogeneous echo pattern and a regular outer margin of the pancreas. Abnormal EUS findings were present in all patients with ERP-stages II and III and in 88% of patients with ERP-stage I. 63% of patients with a normal pancreatogram, i.e. ERP-stage 0 showed pathological alterations on EUS examination. Diffuse alterations of the echopattern were seen in 75% of CP patients with stage I, in 88% with stage II and in 96% with stage III. Alternating echo-poor/echo-dense areas were present in 50% of stage I, in 88% of stage II, and in 81% of stage III cases, respectively. 38% of stage I, 56% of stage II, and 27% of stage III cases displayed a lobulated appearance of pancreatic parenchyma. In 80% of the patients these findings were combined with an irregularly lined pancreatic surface. This same combination of EUS-findings in proven CP was also present in 30% of patients with completely normal pancreatic ducts, i.e. ERP-stage 0. Changes of the main pancreatic duct in stages II and III were also seen with EUS in 81% and 96%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Nattermann
C
C
Medizinische Klinik II, Städtischen Kliniken Offenbach, J.W. Goethe-Universität, Frankfurt/Main.
Goldschmidt
A J
AJ
Dancygier
H
H
D000328:Adult; D000368:Aged; D001699:Biometry; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000473:pathology; D012016:Reference Values; D014463:Ultrasonography
Endosonographie bei chronischer Pankreatitis. Eine vergleichende Studie zwischen endoskopisch-retrograder Pankreatikographie und endoskopischer Sonographie.