Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1

Background and Aims. Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound...

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Main Authors: Mazen Shobassy, Nedaa Husainat, Abdalaziz Tabash, Kalpesh Patel, Hashem B. El-Serag, Mohamed O. Othman
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/5290642
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author Mazen Shobassy
Nedaa Husainat
Abdalaziz Tabash
Kalpesh Patel
Hashem B. El-Serag
Mohamed O. Othman
author_facet Mazen Shobassy
Nedaa Husainat
Abdalaziz Tabash
Kalpesh Patel
Hashem B. El-Serag
Mohamed O. Othman
author_sort Mazen Shobassy
collection DOAJ
description Background and Aims. Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound (EUS) findings for patients with low FE-1. Methods. A retrospective cross-sectional study was performed in 40 patients who had low FE-1 and underwent EUS to evaluate the pancreas. We obtained data on demographic and lifestyle factors, EUS findings, and histopathology results. We compared these variables between patients with FE‐1<100 mcg/g vs. 100-200 mcg/g. Results. Most patients (82.5%) established one or more new diagnoses from EUS. Diagnoses included: definitive chronic pancreatitis (n=29, 72.5%), fatty pancreas (n=9, 22.5%), and pancreatic solid mass or cyst (n=9, 22.5%). Half (n=4) of the solid or cystic lesions were neoplastic. All patients with a solid pancreatic mass also had concurrent chronic pancreatitis. There were no significant differences in EUS findings or demographic or lifestyle factors between groups with FE‐1<100 mcg/g vs. 100-200 mcg/g. Conclusion. Chronic pancreatitis is the most common EUS finding in patients with low FE-1 levels. EUS appears helpful in determining the cause of EPI in most patients with low FE-1 and may detect unsuspected pancreatic neoplasia.
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spelling doaj-art-33250680b6d1478b8342f7b2bb50edec2025-08-20T02:24:21ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/52906425290642Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1Mazen Shobassy0Nedaa Husainat1Abdalaziz Tabash2Kalpesh Patel3Hashem B. El-Serag4Mohamed O. Othman5Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASection of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USABackground and Aims. Fecal elastase-1 (FE-1) as a screening test for exocrine pancreatic insufficiency (EPI) is gaining popularity in clinical practice. The role of imaging in patients with FE-1-related suspicion of EPI remains unclear. The aim of this study was to characterize endoscopic ultrasound (EUS) findings for patients with low FE-1. Methods. A retrospective cross-sectional study was performed in 40 patients who had low FE-1 and underwent EUS to evaluate the pancreas. We obtained data on demographic and lifestyle factors, EUS findings, and histopathology results. We compared these variables between patients with FE‐1<100 mcg/g vs. 100-200 mcg/g. Results. Most patients (82.5%) established one or more new diagnoses from EUS. Diagnoses included: definitive chronic pancreatitis (n=29, 72.5%), fatty pancreas (n=9, 22.5%), and pancreatic solid mass or cyst (n=9, 22.5%). Half (n=4) of the solid or cystic lesions were neoplastic. All patients with a solid pancreatic mass also had concurrent chronic pancreatitis. There were no significant differences in EUS findings or demographic or lifestyle factors between groups with FE‐1<100 mcg/g vs. 100-200 mcg/g. Conclusion. Chronic pancreatitis is the most common EUS finding in patients with low FE-1 levels. EUS appears helpful in determining the cause of EPI in most patients with low FE-1 and may detect unsuspected pancreatic neoplasia.http://dx.doi.org/10.1155/2019/5290642
spellingShingle Mazen Shobassy
Nedaa Husainat
Abdalaziz Tabash
Kalpesh Patel
Hashem B. El-Serag
Mohamed O. Othman
Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
Gastroenterology Research and Practice
title Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
title_full Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
title_fullStr Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
title_full_unstemmed Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
title_short Endoscopic Ultrasound Findings in Patients Diagnosed with Exocrine Pancreatic Insufficiency by Low Fecal Elastase-1
title_sort endoscopic ultrasound findings in patients diagnosed with exocrine pancreatic insufficiency by low fecal elastase 1
url http://dx.doi.org/10.1155/2019/5290642
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