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Korean J Med > Volume 88(4); 2015 > Article
The Korean Journal of Medicine 2015;88(4): 387-392.
옱諛쒖꽦 듅諛쒖꽦 痍뚯옣뿼쓽 吏꾨떒 젒洹
李⑥긽슦
닚泥쒗뼢븰援 쓽怨쇰븰 닚泥쒗뼢븰援 꽌슱蹂묒썝 냼솕湲곕궡怨
Diagnostic Approach to Recurrent Idiopathic Pancreatitis
Sang-Woo Cha
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
Corresponding Author: Sang-Woo Cha ,Tel: +82-2-709-9202, Fax: +82-2-709-9696, Email: swcha@schmc.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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ABSTRACT
Acute recurrent pancreatitis (ARP) most commonly results from alcohol abuse or gallstone disease. Nevertheless, the initial evaluation fails to detect the cause of ARP in 20% to 30% of patients, who are thus diagnosed with idiopathic pancreatitis. Further evaluation is indicated in patients with a severe initial attack of acute pancreatitis or those with two or more attacks. This evaluation might include one or more of the following procedures: specialized laboratory studies, endoscopic ultrasonography (EUS), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP). Based on our experience, the initial step in this evaluation should be MRCP or EUS because of the high safety and diagnostic yield of these techniques. If MRCP or EUS is negative, then ERCP with sphincter of Oddi manometry, intraductal ultrasonography (IDUS), or bile analysis should be considered.
Keywords: Recurrent; Idiopathic; Pancreatitis; Diagnosis
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