Ultrasound imaging in tropical pancreatitis.

Tropical pancreatitis differs in many respects from the chronic pancreatitis seen in Western countries. The present study was carried out to evaluate the role of ultrasonography in the diagnosis of tropical pancreatitis (TP) and to characterize the ultrasound findings in tropical pancreatitis. Patients referred with a suspected diagnosis of tropical pancreatitis formed the subjects for the study. Plain x-rays of the abdomen, ultrasonography, and endoscopic retrograde cholangio-pancreatography (ERCP) were carried out in all cases. Of the 25 cases, 17 patients had ERCP evidence of pancreatitis. Duct dilatation (82%) and demonstration of calculi were the most common ultrasound findings. Pancreatic atrophy (53%) was also a major feature of TP. Compared with ERCP, ultrasonography had a sensitivity of 94% and a specificity of 100%. Only one case with mild changes in ERCP was missed by ultrasonography. For the diagnosis and planning of surgery in TP, ultrasonography can replace ERCP. Even complications like cysts and malignancies are detected by ultrasonography.