Endoscopic ultrasonography in a child with chronic pancreatitis

In a case with chronic pancreatitis and pseudocysts related to muscular cytochrome-c oxidase deficiency, endoscopic ultrasonography (EUS) was performed to morphologically examine the pancreas for features that may have been missed by abdominal computed tomography and pancreatography. Conventional abdominal sonography had failed to show valuable diagnostic information of chronic pancreatitis in this case. EUS demonstrated several new findings. Parenchymal atrophy was remarkable, especially in the pancreatic tail, and a dilated pancreatic main or branch duct was clearly found in the region. Moreover, pancreatic stones in the main duct were also distinctly proved. EUS may become a useful new diagnostic method in pediatric gastroenterology, especially when sufficient findings are not obtained by conventional imaging techniques. However, an ultrasonographic endoscope with a shorter rigid portion and smaller caliber should be developed for pediatric patients.