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

 Jae Hee Cho  ;  Tae Joo Jeon  ;  Ja Sung Choi  ;  Hee Man Kim  ;  Ji Young Park  ;  Yu Jin Kim  ;  Ki Jun Han  ;  Hyeon Geun Cho  ;  Seungmin Bang  ;  Si Young Song 
 PANCREATOLOGY, Vol.12(6) : 495-501, 2012 
Journal Title
Issue Date
Abdominal Pain ; Acute Disease ; Adult ; Aged ; Endosonography* ; Female ; Fever ; Humans ; Length of Stay ; Male ; Middle Aged ; Pancreatitis/diagnostic imaging* ; Pancreatitis/etiology ; Pancreatitis/pathology ; Prognosis
Endoscopic ultrasonography ; Acute pancreatitis ; Severity
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Jin(김유진)
Kim, Hee Man(김희만)
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Cho, Jae Hee(조재희)
Cho, Hyeon Geun(조현근)
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