Endoscopic ultrasonography is a valuable diagnostic tool in patients with incidental findings in the pancreas or bile ducts

Abstract

Introduction: Incidental findings are often seen at computed tomographies (CT). This study describes patients who had an endoscopic ultrasonography (EUS) because of an incidental finding in the pancreas/bile duct.

Methods: Patients referred for EUS between September 2012 and September 2013 because of an incidental finding in the pancreas/bile duct at a CT were prospectively enrolled. After EUS, the findings of this procedure were noted together with the plan for further diagnostic work-up or therapy. A follow-up was made after 6 months and 1 year after EUS was performed.

Results: A total of 47 patients (24 women, 23 men) were registered with an incidental finding. The median age was 69 years (range: 45-83 years). Diagnoses after performing EUS were: normal findings (n = 16), cystic lesion (n = 16), mass lesion (n = 6), inconclusive (n = 6) and other specified (n = 3). The plan after EUS was: no further evaluation (n = 27), referred for new EUS or other imaging procedures (n = 14) and referred for surgery/endoscopic retrograde cholangiopancreatography (n = 6). In total, 6 patients proved to have neoplastic diseases in the pancreas. None of the patients who were stopped from further evaluation following EUS later proved to have a malignant disease in the pancreas.

Conclusion: EUS is a valuable diagnostic tool in patients with incidental findings in the pancreas/bile duct noted at a CT. Many patients can be stopped from further diagnostic work-up after EUS with a minimal risk of overlooking a malignant disease.

Funding: not relevant.

Trial registration: The study was approved by the Danish Data Protection Agency via Region of Southern Denmark (case no. 13/27,321).