The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population
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The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population Suril Patel, Jarred Marshak, Fredric Daum, Shahzad Iqbal New York, USA
Data sources: English language articles on the use of pediatric endoscopic ultrasound in evaluating pancreaticobiliary diseases were retrieved from PubMed/ MEDLINE. Results: We analyzed various retrospective studies and case series publications. Data was extrapolated for pediatric patients with pancreaticobiliary diseases. Conclusions: EUS offers superior imaging. It is comparible to magnetic resonance imaging and/or pancreatic-protocol computed tomography. In the current literature, there are a variety of pancreaticobiliary conditions where EUS was utilized to make a diagnosis. These include recurrent pancreatitis, congenital anomalies, microlithiasis, pancreatic pseudocysts, and pancreatic mass lesions. EUS was shown to be a safe and cost-effective modality with both diagnostic and therapeutic capabilities in the pediatric population. EUS is now increasingly being recognized as a standard of care when evaluating pancreaticobiliary conditions in children. World J Pediatr April 2017; Online First Key words: endoscopic ultrasound; pancreatic mass; pancreaticobiliary
Author Affiliations: Department of Internal Medicine, Winthrop University Hospital (Patel S, Marshak J, Daum F); Department of Internal Medicine, Division of Gastroenterology, Winthrop University Hospital, Hepatology, and Nutrition (Iqbal S) Corresponding Author: Suril Patel, MD, Department of Internal Medicine,Winthrop University Hospital, 180 Hilton Ave, Apt #D1, Hempstead, NY 11550, USA (Tel: 407-697-8744; Email: [email protected]) doi: 10.1007/s12519-017-0020-y ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2017. All rights reserved.
World J Pediatr, Online First . April 2017 . www.wjpch.com
Introduction
E
valuating pancreaticobiliary conditions in children often requires the specialty of a gastroenterologist. Endoscopic ultrasound (EUS) is becoming a more popular diagnostic and therapeutic tool for gastroenterologists, and can be effectively utilized in the pediatric population. The close proximity of the gastric and duodenal lumen to the pancreas and biliary tract results in high-resolution images. EUS offers superior imaging with performance comparable to magnetic resonance imaging (MRI) and pancreatic-protocol computed tomography (CT). Although endoscopic retrograde cholangiopancreatography (ERCP) has traditionally been used in the evaluation of different pancreaticobiliary diseases, it is invasive with 2.5% to 11% complication rate in children. [1] This article will review the emerging role of EUS in different pancreaticobiliary conditions in the pediatric population.
Equipment
EUS was first introduced in the 1980s. [2] A special ultrasound probe was installed to the tip of an endoscope, and a water-filled balloon surrounds the ultrasound transducer to enhance the acoustic coupling. Due to the close prox
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