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

 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 
 Pancreatology, Vol.12(6) : 495-501, 2012 
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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. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김유진(Kim, Yoo Jin) ; 김희만(Kim, Hee Man) ; 방승민(Bang, Seung Min) ; 송시영(Song, Si Young) ; 조재희(Cho, Jae Hee) ; 조현근(Cho, Hyeon Geun)
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