Kadyada Srikanth Puttaiah, Thapa Babu Ram, Dhaka Narendra, Bhatia Anmol, Menon Jagadeesh
From the Division of Pediatric Gastroenterology, Department of Gastroenterology.
Department of Gastroenterology, and.
Pancreas. 2019 Mar;48(3):350-355. doi: 10.1097/MPA.0000000000001243.
Endoscopic ultrasound (EUS) is a minimally invasive pancreatic imaging modality. We evaluated children with idiopathic acute pancreatitis (IAP) and acute recurrent pancreatitis (ARP) for changes of chronicity (Rosemont criteria) and biliary risk factors. Diagnostic yield of simultaneously performed transabdominal ultrasonography (TUS) was compared with EUS.
This was a prospective observational study. Patients underwent EUS and TUS after 2 months of pancreatitis attack.
Forty-five (18 IAP, 27 ARP) patients underwent EUS and TUS. Mean (standard deviation) age and weight were 9.1 (2.6) years and 32.66 (12.43) kg in IAP, whereas these were 12.2 (3.1) years and 44.84 (15.12) kg in ARP, respectively. Endoscopic ultrasound demonstrated morphological abnormality in 33.3% and 40.7% of IAP and ARP, respectively (P = 0.61), whereas 16.6% and 25.9% were abnormal in TUS. Endoscopic ultrasound showed unequivocal changes of chronicity (11.1% vs 0%) and risk factors only among ARP (25.9% vs 0%; P = 0.03) and demonstrated slightly higher odds ratio (95% confidence interval) as compared with TUS to detect abnormalities in both IAP (2.43 [0.49-14.17], P = 0.28) and ARP (1.94 [0.60-6.47], P = 0.26).
Applying EUS, changes of chronicity and risk factors were noted only in ARP. Endoscopic ultrasound performed better than TUS in detecting chronicity.
内镜超声（EUS）是一种微创胰腺成像方式。我们评估了患有特发性急性胰腺炎（IAP）和急性复发性胰腺炎（ARP）的儿童的慢性化改变（罗斯蒙特标准）和胆道危险因素。将同时进行的经腹超声检查（TUS）的诊断率与EUS进行了比较。
这是一项前瞻性观察性研究。患者在胰腺炎发作2个月后接受了EUS和TUS检查。
45例（18例IAP，27例ARP）患者接受了EUS和TUS检查。IAP患者的平均（标准差）年龄和体重分别为9.1（2.6）岁和32.66（12.43）kg，而ARP患者的平均年龄和体重分别为12.2（3.1）岁和44.84（15.12）kg。内镜超声显示IAP和ARP患者中分别有33.3%和40.7%存在形态学异常（P = 0.61），而TUS检查中异常的比例分别为16.6%和25.9%。内镜超声仅在ARP患者中显示出明确的慢性化改变（11.1%对0%）和危险因素（25.9%对0%；P = 0.03），并且与TUS相比，在检测IAP（优势比[95%置信区间]为2.43[0.49 - 14.17]；P = 0.28）和ARP（优势比[95%置信区间]为1.94[0.60 - 6.47]；P = 0.26）的异常方面显示出略高的优势比。
应用EUS时，仅在ARP患者中发现了慢性化改变和危险因素。内镜超声在检测慢性化方面比TUS表现更好。
