1.The Utility of Endoscopic Ultrasound in Patients with Isolated Elevations in Serum Amylase and/or Lipase
Lalitha M SITARAMAN ; Amit H SACHDEV ; Tamas A GONDA ; Amrita SETHI ; John M PONEROS ; Frank G GRESS
Clinical Endoscopy 2019;52(2):175-181
		                        		
		                        			
		                        			BACKGROUND/AIMS: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolated elevated 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 selected based on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patients were 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 frequently abdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or new diagnosis 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%) had cholecystectomy. 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.
		                        		
		                        		
		                        		
		                        			Abdominal Pain
		                        			;
		                        		
		                        			Academic Medical Centers
		                        			;
		                        		
		                        			Amylases
		                        			;
		                        		
		                        			Bile
		                        			;
		                        		
		                        			Cholecystectomy
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Endosonography
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lipase
		                        			;
		                        		
		                        			Liver Function Tests
		                        			;
		                        		
		                        			Pancreas
		                        			;
		                        		
		                        			Pancreatic Cyst
		                        			;
		                        		
		                        			Pancreatitis
		                        			;
		                        		
		                        			Pancreatitis, Chronic
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Sewage
		                        			;
		                        		
		                        			Ultrasonography
		                        			
		                        		
		                        	
            
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