title: Pancreato-biliary Endoscopic Ultrasound in Opium Addicts Presenting with Abdominal Pain.
abstract: OBJECTIVE
  Asymptomatic dilatation of bile duct and symptomatic sphincter of Oddi dysfunction have been reported in opium addicts. Except one case report, there is no report in the literature on endoscopic ultrasound (EUS) study of pancreato-biliary system in opium addicts. The aim of the present study was to report the EUS features of pancreato-biliary system in opium addicts presenting with abdominal pain.
  
  
  METHODS
  A total of 15 opium addicts presenting with upper abdominal pain and dilated common bile duct (CBD) and or pancreatic duct (PD) on abdominal ultrasound were included in this study. EUS findings of pancreato-biliary system were analyzed in these patients.
  
  
  RESULTS
  All the 15 patients were males (mean age 53.3 years) presented with upper abdominal pain. Mean duration of opium addiction was 20.1 years. On EUS CBD was dilated in all the patients while PD was dilated in six patients. Gall bladder, liver and pancreatic parenchyma was normal in all these patients. Surface area of papilla of Vater (SPV) was increased in 12 patients.
  
  
  CONCLUSIONS
  Opium addiction causes obstruction at ampulla and produces dilatation of bile duct and PD. Bile duct dilatation was seen in all the patients while PD dilatation was seen in few patients. Increase in SPV was a peculiar finding and appears to be as a result of direct effect of opium on ampulla.
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Shyam Sundar
authors.initials: SS
authors.lastname: Sharma
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Seva
authors.initials: S
authors.lastname: Ram
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Maharshi
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Shankar
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Katiyar
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Jhajharia
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Vimal
authors.initials: V
authors.lastname: Sardava
authors.affiliation: Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
authors.forename: Hemendra
authors.initials: H
authors.lastname: Bhardwaj
keywords: bile duct; endoscopic ultrasound; opium addict; pancreatic duct; papilla of Vater