1. Evaluation of the bilio-pancreatic region using endoscopic ultrasonography in patients referred with and without abdominal pain and CA 19-9 serum level elevation.
- Author
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Ulla Rocha JL, Alvarez Sanchez MV, Paz Esquete J, Fernandez Salgado E, Alvarez Alvarez C, Vazquez Sanluis MJ, Ledo Barro L, and Vazquez Astray E
- Subjects
- Abdominal Pain pathology, Acute Disease, Adenocarcinoma diagnostic imaging, Adenocarcinoma pathology, Biliary Tract Diseases pathology, Biomarkers, Tumor blood, Biopsy, Fine-Needle, Humans, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms pathology, Pancreatitis, Chronic pathology, Retrospective Studies, Abdominal Pain diagnostic imaging, Biliary Tract Diseases diagnostic imaging, CA-19-9 Antigen blood, Endosonography, Pancreatitis, Chronic diagnostic imaging
- Abstract
Context: When assessing the bilio-pancreatic region, collating the findings of serum CA 19-9 values together with findings from various imaging tests--especially endoscopic ultrasonography--is not a simple issue in daily clinical practice., Aim: To assess the usefulness of endoscopic ultrasonography in an Endoscopic Ultrasonography Unit in two situations: patients with asymptomatic elevation of serum CA 19-9 and patients who presented with abdominal pain plus elevation of CA 19-9., Methods: A retrospective study of those patients who underwent radial endoscopic ultrasonography between October 2004 and September 2005 in our institution, considering an elevation of CA 19-9 (equal to or greater than 37 U/mL) with or without symptoms. In each case, the parameters recorded were: levels of CA 19-9 one week before EUS, results from other imaging techniques (US, helical CT), and final diagnosis according to pathological and/or clinical evolution criteria. Patients with previous attacks of acute pancreatitis and also those who presented with bile duct dilation or space-occupying lesions in image studies (US and CT) were excluded. Twenty-two patients met the inclusion criteria., Results: Asymptomatic elevation of CA 19-9 was found in 15 patients while 7 patients had elevated CA 19-9 levels as well as pain of uncertain origin. The results of EUS in the asymptomatic patients were: chronic pancreatitis in 7 patients, no pancreatic alterations in 3 patients, and renal cysts, choledocholithiasis, microlithiasis and liver cirrhosis in one patient, respectively. In patients with abdominal pain, EUS showed chronic pancreatitis in 6 cases and adenocarcinoma of the tail of the pancreas in the remaining patient., Conclusions: When EUS was indicated for the asymptomatic elevation of CA 19-9, the main findings were benign diseases. EUS was useful in studying patients with idiopathic abdominal pain and a slight elevation of CA 19-9 since it allowed us to detect chronic pancreatitis and even early adenocarcinoma of the pancreatic tail.
- Published
- 2007