title: Prospective comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the etiological diagnosis of "idiopathic" acute pancreatitis.
abstract: OBJECTIVE
  The objectives of the study were to compare endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP) in the etiological diagnosis of patients initially diagnosed with idiopathic acute pancreatitis and to determine the clinical and analytical factors related to the end result of these techniques.
  
  
  METHODS
  Forty-nine patients, initially diagnosed with idiopathic acute pancreatitis, were evaluated prospectively with EUS and MRCP. Diagnoses were compared between the 2 procedures. The clinical-evolutionary characteristics of these patients with regard to the results obtained with these techniques were compared.
  
  
  RESULTS
  In twenty-eight patients (57%), EUS and/or MRCP diagnosed at least 1 possible cause of acute pancreatitis. The diagnostic yield of EUS was higher than that of MRCP (51% vs 20%; P = 0.001). Cholelithiasis and biliary sludge (24%) were the most frequent EUS diagnoses, and pancreas divisum (8%) was the most frequent MRCP diagnosis. Only in 3 cases (6%) did MRCP identify additional features in patients etiologically undiagnosed using EUS. The EUS yield was lower in patients who had a previous cholecystectomy (11% vs 60%; P = 0.008).
  
  
  CONCLUSIONS
  Endoscopic ultrasonography and MRCP are useful techniques in the etiological diagnosis of acute pancreatitis of nonestablished cause. Endoscopic ultrasonography should be preferred for establishing a possible biliary etiology in patients who have not had a cholecystectomy.
authors.affiliation: Department of Gastroenterology, Virgen de la Salud Hospital, Toledo, Spain. arepiso@sescam.jccm.es
authors.forename: Alejandro Repiso
authors.initials: AR
authors.lastname: Ortega
authors.forename: Rafael
authors.initials: R
authors.lastname: Gómez-Rodríguez
authors.forename: Marta
authors.initials: M
authors.lastname: Romero
authors.forename: Soledad
authors.initials: S
authors.lastname: Fernández-Zapardiel
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Céspedes
authors.forename: José-María
authors.initials: JM
authors.lastname: Carrobles
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001646:Bile; D016009:Chi-Square Distribution; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013030:Spain