What are the endoscopic ultrasonography (EUS) criteria for diagnosis of chronic pancreatitis?

Updated: Jul 15, 2019
  • Author: Jason L Huffman, MD; Chief Editor: BS Anand, MD  more...
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Eleven sonographic criteria have been developed that identify characteristic findings of chronic pancreatitis. The most predictive endosonographic feature is the presence of stones. Other suggestive features include the following:

  • Visible side branches

  • Cysts

  • Lobularity

  • An irregular main pancreatic duct

  • Hyperechoic foci and strands

  • Dilation of the main pancreatic duct

  • Hyperechoic margins of the main pancreatic duct

Before 2001, three or more of these criteria on EUS were used to diagnose chronic pancreatitis. However, subsequent data has suggested the use of five or more criteria to have higher specificity, rather than sensitivity, to diagnose chronic pancreatitis. In general, the presence of five or more of these features is considered highly suggestive of chronic pancreatitis.

EUS may be as sensitive and specific as tube tests for mild and advanced disease, especially when combined with fine needle aspiration or Tru-Cut biopsy.

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