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EUS finding of geographic hyperechoic area is an early predictor for severe acute pancreatitis

Title
EUS finding of geographic hyperechoic area is an early predictor for severe acute pancreatitis
Authors
Jae Hee Cho;Tae Joo Jeon;Si Young Song;Seungmin Bang;Hyeon Geun Cho;Ki Jun Han;Yu Jin Kim;Ji Young Park;Hee Man Kim;Ja Sung Choi
Issue Date
2012
Journal Title
Pancreatology
ISSN
1424-3903
Citation
Pancreatology, Vol.12(6) : 495~501, 2012
Abstract
BACKGROUND/OBJECTIVES: Endoscopic ultrasonography (EUS) is an accurate imaging modality for delineating pancreatobiliary structures, however, its clinical application of acute pancreatitis (AP) is limited. Therefore, we sought to characterize the typical EUS features of AP and to determine whether early EUS findings may have prognostic significance. METHODS: Between March 2008 and October 2010, 90 patients with AP and 90 patients without pancreatic disease who underwent EUS were enrolled. An EUS examination was performed within 48 h of admission in AP, and all EUS findings were retrospectively analyzed. RESULTS: Among 90 patients, 27 (30%) were diagnosed with severe AP. Multivariate analysis revealed the presence of peripancreatic fluid (OR 13.9, 95%, CI: 1.6-123.6), heterogenous (OR 7.2, 95% CI: 1.7-30.4) and hypoechoic parenchymal echogenicity (OR 10.0, 95% CI: 3.9-25.8) were significant EUS features in AP, as compared to those in the control group. Comparison between mild and severe AP showed that geographic hyperechoic area (GHA) of pancreas was a predictive factor (OR 2.9, 95% CI: 1.1-8.2, p = 0.04) for the severe form, and that AP patients with GHA had significantly longer duration of fever, abdominal pain and hospital stay than those without GHA (5.5 vs. 1 day (s), p = 0.002; 4 vs. 3 days, p = 0.023; 11 vs. 8 days, p = 0.021, respectively). CONCLUSIONS: Typical EUS features of AP are a heterogenous hypoechoic parenchymal changes with peripancreatic fluid collection. The novel EUS variable of GHA in the early phase of AP seems to have prognostic value and could be correlated with a worse clinical outcome.
URI
http://www.sciencedirect.com/science/article/pii/S1424390312001937

http://ir.ymlib.yonsei.ac.kr/handle/22282913/91636
DOI
10.1016/j.pan.2012.08.007
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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