The Utility of Endoscopic Ultrasound in Patients with Isolated Elevations in Serum Amylase and/or Lipase
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Background/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolatedelevated levels of amylase and/or lipase. Methods: A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selectedbased on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patientswere excluded if they had abnormal liver function tests or abnormal imaging of the pancreas. Results: Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequentlyabdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or newdiagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1),and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) hadcholecystectomy. Conclusions: In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS,approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.
Abstract
Background/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolatedelevated levels of amylase and/or lipase. Methods: A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selectedbased on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patientswere excluded if they had abnormal liver function tests or abnormal imaging of the pancreas. Results: Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequentlyabdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or newdiagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1),and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) hadcholecystectomy. Conclusions: In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS,approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.
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