title: A prospective, quantitative assessment of the effect of ethanol and other variables on the endosonographic appearance of the pancreas.
abstract: OBJECTIVE
  Studies comparing endosonography with endoscopic pancreatography, histological examination, and functional assays show that the number of endosonographic abnormalities (or "criteria") increases with the severity of chronic pancreatitis. However, it is unclear to what extent such variables as demographics, body habitus, and routine exposure to such pancreatic toxins as ethanol and cigarette smoke can affect pancreatic endosonography. The aim of the study is to quantify the effects of these variables precisely.
  
  
  METHODS
  Pancreatic endosonography was performed by a single operator in consecutive patients referred for any indication. The relationship between 8 possible endosonographic criteria and these variables was studied.
  
  
  RESULTS
  One thousand one hundred fifty-seven patients were studied (93% of eligible patients). Number of criteria correlated most strongly with ethanol ingestion (r = 0.273; P = 0.0001) and smoking history (r = 0.201; P = 0.0001). It did not correlate with age or body mass index. The strongest independent predictors of severe pancreatic abnormalities (>/=5 criteria) were heavy ethanol ingestion (odds ratio [OR], 5.1; 95% confidence interval [CI], 3.1-8.5), male sex (OR, 1.8; 95% CI, 1.3-2.55), clinical suspicion of pancreatic disease (OR, 1.7; 95% CI, 1.2-2.3), and heavy smoking (OR, 1.7; 95% CI, 1.2-2.4). Severe endosonographic abnormalities were found in only 2 of 51 patients (3.9%) with no risk factors or symptoms of pancreatic disease.
  
  
  CONCLUSIONS
  Several variables can affect the endosonographic appearance of the pancreas independently. Severe abnormalities may be asymptomatic. The clinical, functional, and histological significance of endosonographic abnormalities requires clarification.
authors.affiliation: Centre Hospitalier de L'Universite de Montreal, Hopital Saint Luc, Quebec, Canada.
authors.forename: Ian F
authors.initials: IF
authors.lastname: Yusoff
authors.forename: Anand V
authors.initials: AV
authors.lastname: Sahai
mesh_terms: D019160:Endosonography; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000187:drug effects*; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging*; D019512:Pancreatitis, Alcoholic / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012907:Smoking
chemical_list: D000431:Ethanol