Endoscopic ultrasonography of chronic pancreatitis and pancreatic pseudocysts.

Endoscopic ultrasonography has been applied to 30 patients with suspected pancreatitis. All were difficult clinical problems which had not been resolved by conventional ultrasonography. CT scanning, and pancreatography. There were 7 technical failures where the instrument could not be advanced through the pylorus. A definite result was produced in 23 patients. In 7 the EUS findings were confirmed by histology obtained at surgery. In 6 a definite diagnosis of mild chronic pancreatitis was made. Previously undescribed morphological features such as peri-ductal fibrosis, branch duct ectasia and lobular inflammation were shown and correlated with the histological appearance. In 10 patients an EUS diagnosis of a normal pancreas has not been challenged after clinical follow up of six months to two years. The high resolution of EUS is capable of showing unique morphological detail in pancreatitis.