Comparison of endoscopic ultrasound and secretin testing for the diagnosis of chronic pancreatitis

Louis Lambiase, C. E. Forsmark

Research output: Contribution to journalArticle

Abstract

Introduction: The diagnosis of chronic pancreatitis (CP) can be particularly difficult in its early stages, when obvious structural changes are not present. Hormonal stimulation tests have traditionally been used to diagnose this group of patients. Endoscopic ultrasonography (EUS) allows much better definition of pancreatic parenchyma than standard imaging studies, and some have suggested this technique is able to diagnose CP in its early stages. No direct comparisons exist comparing EUS to standard hormonal stimulation testing. Aim: To compare EUS with secretin testing (ST) in patients with suspected CP without easily identifiable structural changes. Methods: Seven non-alcoholic patients with abdominal pain and normal conventional imaging studies (CT in all, ERCP in 6/7) underwent both EUS and ST. The EUS was performed with the Olympus GFUM20 and the pancreas was imaged in the head, body, and tail. The EUS results were read by one examiner (CEF) who was blinded to the results of ST. As previously published, EUS criteria for CP included focal decrease in echogenicity of pancreatic parenchyma, stones, accentuated lobular pattern, cysts, ductal irregularity, ductal dilation, or increased echogenicity of duct wall. Greater than three criteria is considered to be diagnostic of CP. ST was performed as previously described and considered abnormal if the peak (HCO3) was <80 mEq/L in each of the four-15 minute collection periods. Results: 5/7 patients had CP by ST. All patients had at least 1 EUS finding but none had more than three findings. The table compares the results of EUS and ST: ST + ST - EUS+ 1 1 EUS- 4 1 Conclusions: ST and EUS correlated poorly in this group of patients. Further studies are needed to define the utility of EUS in suspected CP with normal conventional imaging studies.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Endosonography
Secretin
Chronic Pancreatitis
Endoscopic Retrograde Cholangiopancreatography
Abdominal Pain
Cysts
Dilatation
Pancreas

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Comparison of endoscopic ultrasound and secretin testing for the diagnosis of chronic pancreatitis. / Lambiase, Louis; Forsmark, C. E.

In: Gastrointestinal Endoscopy, Vol. 45, No. 4, 01.01.1997.

Research output: Contribution to journalArticle

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