scholarly journals Fecal Elastase Levels Predict Honeycombing in Pancreas Detected with Endoscopic Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Sinan Akay ◽  
Burcu Şirin ◽  
Belkıs Ünsal
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Significant Relation ◽  
Fecal Elastase ◽  
Ordinal Logistic Regression Analysis ◽  
Consistent Group ◽  
The Difference ◽  
Subepithelial Lesions ◽  
Elastase Level ◽  
Upper Gastrointestinal

Background and Study Aims. We aimed to demonstrate the association between fecal elastase levels and Rosemont categories in patients with chronic changes in pancreas detected with endoscopic ultrasound. Patients and Methods. Patients were selected consecutively from endosonography examinations performed for upper gastrointestinal subepithelial lesions and for pancreas evaluation. Pancreas imaging findings were categorized according to the Rosemont criteria using echoendoscope. Patients who were indeterminate of, suggestive of, and consistent with chronic pancreatitis were included in the study. Fecal elastase measurements were performed after the patients were qualified to participate in the study according to endosonography findings. Results. Seventy patients were included in the study. 54 of them were male. Mean age of the patients was 51.7 ± 10.2 year. There were 36 patients in the indetermine group for chronic pancreatitis. Mean fecal elastase level was 507.1 ± 14.6 μg/g in the indeterminate group. There were 24 patients in the suggestive group of chronic pancreatitis. Mean fecal elastase level was 400.4 ± 121.4 μg/g in the suggestive group of chronic pancreatitis. There were 10 patients, in the consistent group with chronic pancreatitis. Mean fecal elastase level was 134.8 ± 86.1. The difference between the three groups of fecal elastase values was statistically significant compared with Kruskal Wallis test. Ordinal logistic regression analysis showed that there was a significant relation between endosonografic categories and fecal elastase values with Nagelkerke value of 0.704. Conclusions. Fecal elastase levels of each of the endosonographic categories were significantly different from each other. Also, fecal elastase values can predict chronic changes in pancreas detected with endoscopic ultrasound.

scholarly journals Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Mazen Shobassy ◽  
Nedaa Husainat ◽  
Abdalaziz Tabash ◽  
Kalpesh Patel ◽  
Hashem B. El-Serag ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Pancreatic Insufficiency ◽  
Cross Sectional Study ◽  
Lifestyle Factors ◽  
Exocrine Pancreatic Insufficiency ◽  
Cross Sectional ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Pancreatic Neoplasia

Background and Aims. Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound (EUS) findings for patients with low FE-1. Methods. A retrospective cross-sectional study was performed in 40 patients who had low FE-1 and underwent EUS to evaluate the pancreas. We obtained data on demographic and lifestyle factors, EUS findings, and histopathology results. We compared these variables between patients with FE‐1<100 mcg/g vs. 100-200 mcg/g. Results. Most patients (82.5%) established one or more new diagnoses from EUS. Diagnoses included: definitive chronic pancreatitis (n=29, 72.5%), fatty pancreas (n=9, 22.5%), and pancreatic solid mass or cyst (n=9, 22.5%). Half (n=4) of the solid or cystic lesions were neoplastic. All patients with a solid pancreatic mass also had concurrent chronic pancreatitis. There were no significant differences in EUS findings or demographic or lifestyle factors between groups with FE‐1<100 mcg/g vs. 100-200 mcg/g. Conclusion. Chronic pancreatitis is the most common EUS finding in patients with low FE-1 levels. EUS appears helpful in determining the cause of EPI in most patients with low FE-1 and may detect unsuspected pancreatic neoplasia.

scholarly journals Reliability of Endoscopic Ultrasound Using Miniprobes and Grayscale Histogram Analysis in Diagnosing Upper Gastrointestinal Subepithelial Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Samiullah Khan ◽  
Rui Zhang ◽  
Weili Fang ◽  
Tao Wang ◽  
Shu Li ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Endoscopic Ultrasound ◽  
Muscularis Propria ◽  
Histogram Analysis ◽  
Muscularis Mucosa ◽  
Stromal Tumors ◽  
Subepithelial Lesions ◽  
Upper Gastrointestinal ◽  
Diagnostic Consistency

Background. To assess the role of endoscopic ultrasound (EUS) in the diagnosis of upper gastrointestinal subepithelial lesions (SELs) and to investigate EUS combined with a grayscale histogram analysis for the differentiation of leiomyomas and gastrointestinal stromal tumors (GISTs). Methods. A retrospective study of 709 patients with upper gastrointestinal SELs was conducted by EUS before endoscopic resection. The EUS findings of SELs and pathological results after endoscopic resection were compared. The EUS images of SELs, particularly, leiomyoma and GIST, were further analyzed via a grayscale histogram to differentiate between the two tumors. Results. Of the 709 patients, 47 cases were pathologically undetermined. The diagnostic consistency of EUS with endoscopic resection was 88.2% (584/662), including 185 muscularis mucosa, 61 submucosa, and 338 muscularis propria, respectively. The diagnostic consistency of EUS with pathology was 80.1% (530/662). The gray value of GISTs was significantly higher than that of leiomyomas (58.9±8.3 vs. 39.5±5.9, t=57.0, P<0.0001). The standard deviation of leiomyomas was significantly lower than that of GISTs (20.6±7.0 vs. 39.8±9.3, t=23.7, P<0.0001). The grayscale histogram analysis of GISTs showed higher echo ultrasound, and the echo of leiomyoma was more uniform. Conclusion. EUS is the preferred procedure for the evaluation of upper gastrointestinal SELs. EUS combined with a grayscale histogram analysis is an effective method for the differentiation of leiomyomas and GISTs.

scholarly journals Frey’s procedure: short term follow up results in terms of pain, endocrine and exocrine status, a tertiary care centre experience

2020 ◽  
Vol 8 (6) ◽  
pp. 2123
Author(s):  
C. Sugumar ◽  
S. Balakumaran ◽  
Mukund Mundra
Keyword(s):  
Chronic Pancreatitis ◽  
Nutritional Status ◽  
Pain Score ◽  
Pain Control ◽  
Financial Burden ◽  
Tertiary Care ◽  
Frey’S Procedure ◽  
Fecal Elastase ◽  
Significant Difference ◽  
Elastase Level

Background: Chronic pancreatitis, a debilitating disease which affects the patient to an extent to render him bedridden sometimes and often make him/her unable to perform daily work, leading to poor quality of life, severe emotional stress and financial burden. Frey’s procedure one of the most commonly performed surgery in patient of chronic pancreatitis with stones in pancreatic duct and small inflammatory head mass. This procedure had shown promising results in terms of pain control with unclear outcome with respect to exocrine and endocrine status.Methods: Study was conducted in Government Kilpauk Medical College, Chennai during March 2016 to December 2019. Total 21 patients were followed up for 18 months and Post-operative pain was analysed using pain scoring system used by Bloechle et al. Exocrine status in terms of diarrhea, bloating sensation and Fecal Elastase level(preoperative and postoperative) were analysed. Patient glycaemic status were also analysed and compared. Patient Nutritional status was analysed in terms of weight gain.Results: In this study there was significant improvement in pain after surgery in terms of VAS pain Score (Preop Mean-82.14, Post-op Mean- 9.76, p<0.001) , frequency of pain (Preop Mean-78.57, Post-op Mean- 14.29, p<0.001), analgesia required (Preop Mean-15, Post-op Mean- 3.10, p<0.001), and inability to work due to pain (Preop Mean-80.95, Post-op Mean- 11.90, p<0.001). Overall total Pain score was significantly improved after surgery (Preop Mean-256.67, Post-op Mean- 39.05, p<0.001). There was significant weight gain and significant improvement in Fecal Elastase level in patients following surgery, however there was no significant difference in pancreatic exocrine status on the basis of symptoms.Conclusions: Frey’s procedure is very effective in pain control in properly selected patients of chronic calcific pancreatitis, and it also improves nutritional status of patient. Frey’s procedure might improve patient exocrine and endocrine status but further  multicentre studies are needed to come to a conclusion. 

scholarly journals Endoscopic ultrasound-guided forceps biopsy from upper gastrointestinal subepithelial lesions using a forward-viewing echoendoscope

2016 ◽  
Vol 04 (06) ◽  
pp. E637-E641
Author(s):  
Ippei Matsuzaki ◽  
Ryoji Miyahara ◽  
Yoshiki Hirooka ◽  
Kohei Funasaka ◽  
Takeshi Yamamura ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Forceps Biopsy ◽  
Subepithelial Lesions ◽  
Upper Gastrointestinal

scholarly journals Su1437 ENDOSCOPIC ULTRASOUND FOR EVALUATION OF SMALL VS. LARGE SUBEPITHELIAL LESIONS OF THE UPPER GASTROINTESTINAL TRACT

2018 ◽  
Vol 87 (6) ◽  
pp. AB355-AB356
Author(s):  
Mark H. Hanscom ◽  
Cemal Yazici ◽  
Allan Halline ◽  
Brian R. Boulay ◽  
Bhargava Gannavarapu
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Ultrasound ◽  
Upper Gastrointestinal Tract ◽  
Subepithelial Lesions ◽  
Upper Gastrointestinal

scholarly journals Utility of endoscopic ultrasound in idiopathic acute recurrent pancreatitis

2021 ◽  
Vol 8 (1) ◽  
pp. e000538
Author(s):  
Alejandra Tepox-Padrón ◽  
Rafael Ambrosio Bernal-Mendez ◽  
Gilberto Duarte-Medrano ◽  
Adriana Fabiola Romano-Munive ◽  
Milton Mairena-Valle ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Complete Resolution ◽  
Diagnostic Yield ◽  
Recurrent Pancreatitis ◽  
Mucinous Neoplasm ◽  
Possible Cause ◽  
Symptoms And Signs

Idiopathic acute recurrent pancreatitis (IARP) is defined as at least two episodes of acute pancreatitis with the complete or near-complete resolution of symptoms and signs of pancreatitis between episodes, without an identified cause. There is a paucity of information about the usefulness of endoscopic ultrasound (EUS) in IARP.ObjectivesTo determine the diagnostic yield of EUS in IARP.DesignA retrospective study was performed in patients with IARP evaluated by EUS between January 2009 and December 2016. Follow-up assessments of acute pancreatitis recurrence were carried out.ResultsSeventy-three patients with 102 EUS procedures were included. EUS was able to identify the cause of IARP in 55 patients (75.3%). The most common findings were chronic pancreatitis in 27 patients (49.1%), followed by lithiasic pathology in 24 patients (43.6%), and intraductal papillary mucinous neoplasm in four patients (7.3%). A directed treatment against EUS findings had a protective tendency associated with the final resolution of recurrence. There were no complications reported.ConclusionEUS performed in patients with IARP helped to identify a possible cause in 2/3 of the cases. The majority of patients have a treatable disease.

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