Place of Echo Endoscopy in Unexplained Acute Pancreatitis: A Retrospective Study

Introduction: Acute pancreatitis may escape etiological diagnosis after clinical, biological and morphological investigation in 10-30% of patients. Echo-endoscopy is promising and particularly effective in exploring the bilio-pancreatic region.

The aim of our study is to evaluate the contribution of echo-endoscopy in unexplained acute pancreatitis.

Materials and Methods: This is a retrospective descriptive study, including 89 patients who underwent echoendoscopy for unexplained acute pancreatitis between January 2008 and December 2022.

Results: The mean age of our patients was 55 ± 16.3 years, with extremes ranging from 17 to 89 years. The sex ratio (M/F) was 0.81, with a slight female predominance of 55.1%.

A history of previous acute pancreatitis was found in 31.9% of cases, and 16.3% of patients had undergone cholecystectomy.

The diagnostic yield in our study was 68% of patients. Biliary origin was retained in 40.4% (n=36) of patients; 19 of whom benefited́ from complementary ERCP at the same anesthetic time. A tumor pathology was found in 32.5% of cases (n=30) and chronic pancreatitis in 22.4% of patients (n=20). We also found two cases of pancreas divisum, one case of sphincter of Oddi dysfunction and one case of choledochocele.

Echo-endoscopy was normal in the remaining 32% of cases, with no cause found.

Conclusion: Echo-endoscopy is currently an indispensable tool in the etiological investigation of unexplained acute pancreatitis. In our study, the diagnostic yield was 68%.