[Endoscopic ultrasonography--an addition to pancreas diagnosis?]

Endoscopic ultrasonography (EUS) has been developed for high resolution imaging of the upper gastrointestinal tract and immediate surroundings, such as the pancreas and the biliary tract. The ultrasonic transducer at the tip of the instrument works with ultrasound frequencies of 7.5 MHz and provides delineation of small structures and lesions, but the ultrasonic penetration depth is not sufficient for visualization of organs such as liver, spleen and kidneys. In the diagnosis of pancreatic disease the advantages of EUS lie in the delineation of small endocrine and exocrine tumors of the pancreas, complementary to other procedures such as ultrasound, CT and ERCP. EUS is also the most accurate single diagnostic method in the local staging of pancreatic ampullary carcinoma, being superior to other modalities in the diagnosis of portal venous infiltration. The disadvantage of EUS is its poor ability to differentiate between malignant and focal inflammatory tumors of the pancreas. The role of EUS in the diagnosis of chronic pancreatitis has not yet been fully established.