Prognostic value of endoscopic ultrasound in acute pancreatitis.
OBJECTIVE
Endoscopic ultrasonography (EUS) is a useful modality to diagnose causes of pancreatitis. The role of EUS for prediction of pancreatitis severity has not been studied. The aim of this study was to identify the utility of EUS in determining the severity of acute pancreatitis (AP).


METHODS
All patients diagnosed with pancreatitis consecutively underwent EUS on the 2nd day of their admission. Atlanta criteria were used as the severity index of pancreatitis.


RESULTS
During the study period, 114 patients (74 females, 40 males; mean age of 53.03 ± 17.7 years) were enrolled in the study. The most common cause of AP was gallstone (78.9%). According to the Atlanta criteria, pancreatitis was mild in 72 (63.2%) and severe in 42 (36.8%) patients. In univariate analysis, the presence of peripancreatic edema, pancreas inhomogeneity, common bile duct dilation and ascites were associated with severe pancreatitis. In multivariate analysis, only the presence of peripancreatic edema in EUS correlated with the severity of AP according to the Atlanta criteria (sensitivity, specificity and accuracy: 65.8, 75.7 and 72.2%, respectively).


CONCLUSIONS
EUS may be a new useful imaging modality for prediction of severity of AP and may have prognostic significance in the early phase of AP. and IAP.
Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. setoodeh @ ams.ac.ir
Rasoul
R
Sotoudehmanesh
Afshin
A
Hooshyar
Shadi
S
Kolahdoozan
Fatemeh
F
Zeinali
Shadi
S
Shahraeeni
Abbas-Ali
AA
Keshtkar
D000208:Acute Disease; D019160:Endosonography / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D011379:Prognosis; D011446:Prospective Studies