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Detection of embryologic ventral pancreatic parenchyma with endoscopic ultrasound
T J Savides1, F G Gress, S A Zaidi
1Division of Gastroenterology, Indiana University Medical Center, Indianapolis, USA.
Background:
The prevalence of detecting the embryologic ventral pancreas (ventral anlage) with endoscopic ultrasound (EUS) is unknown.
Purpose:
To determine the frequency of, and factors associated with, EUS findings consistent with the ventral anlage.
Methods:
One hundred patients undergoing upper gastrointestinal EUS for any indication were prospectively evaluated for the presence of a focal, hypoechoic area in the pancreatic head using a radial scanning echoendoscope. Multiple clinical and EUS variables were tested against the ability to detect the ventral anlage.
Results:
The overall detection rate of the ventral anlage was 59%. The ventral anlage was detected in 75% of patients undergoing EUS for nonpancreatic indications, compared to 40% of patients undergoing EUS to evaluate suspected pancreatic disease (p< 0.001). EUS detected the ventral anlage in 72% of patients with a normal EUS-appearing pancreatic head, compared to 29% of patients who had abnormal pancreatic head parenchyma (mass or chronic pancreatitis) on EUS (p < 0.001). Multivariate analysis revealed the only variable associated with detecting the ventral anlage was abnormal pancreatic head parenchyma on EUS.
Conclusion:
The ventral anlage is frequently detected during pancreatic EUS, with a significantly lower rate of detection in patients with EUS findings of a pancreatic head mass or diffuse chronic pancreatitis.