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Experimental and Clinical Gastroenterology

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Endosonographic changes of the pancreas in patients with inflammatory bowel diseases and chronic pancreatitis

https://doi.org/10.31146/1682-8658-ecg-213-5-73-80

Abstract

The aim of the study was to compare endosonographic signs of pancreatic lesion in patients with inflammatory bowel diseases (IBD) and in patients with diagnosed chronic pancreatitis (CP). Materials and methods. 62 patients with IBD (39 with ulcerative colitis (UC), 23 with Crohn’s disease (CD)), 33 patients with previously established CP without IBD and 42 patients without CP and IBD were examined. All patients underwent endosonographic examination of the pancreas with an assessment of parenchymal and ductal criteria according to the Rosemont classification. Results. There was no statistically significant difference when comparing changes in the pancreas in UC and BC. Ductal disorders in patients with UC and CD were more common than in the control group. Parenchymal changes of the pancreas were statistically significantly more common in patients with IBD than in CP, and ductal, on the contrary, less common. At the same time, a significant difference was determined between the frequency of ductal changes in IBD and CP when compared with the control group. According to the Rosemont classification, certain CP was more common in patients with previously verified gland damage, probable - in patients with IBD. Conclusion. Based on the results of our study, with different etiologies of CP, endosonographic changes in the pancreas will manifest in different ways. A detailed approach to the etiology of CP will optimize the diagnosis and treatment of pancreatic insufficiency, and as a consequence of the underlying pathology of the intestine. Timely administration of therapy for changes in the pancreas can help to avoid progressive changes in the pancreas and improve the prognosis of the disease.

About the Authors

A. A. Budzinskaya
Moscow Regional Research and Clinical Institute
Russian Federation


E. A. Belousova
Moscow Regional Research and Clinical Institute
Russian Federation


E. S. Vakurova
Moscow Regional Research and Clinical Institute
Russian Federation


E. U. Lomakina
Moscow Regional Research and Clinical Institute
Russian Federation


References

1. Akhmedov V.A., Gaus O. V. Modern views on the mechanisms of formation and prospects for the relief of abdominal pain in patients with chronic pancreatitis. Experimental and clinical gastroenterology. 2016;134(10):99-103. (In Russ.)@@ Ахмедов В. А., Гаус О. В. Современные взгляды на механизмы формирования и перспективы купирования болевого абдоминального синдрома у пациентов хроническим панкреатитом. Экспериментальная и клиническая гастроэнтерология. 2016;134(10):99-103.

2. Vorobyov G. I. Nonspecific inflammatory bowel disease. Moscow. Miklosh. 2008. (In Russ.)@@ Воробьев Г. И. Неспецифические воспалительные заболевания кишечника. М.: Миклош; 2008.

3. Crohn B.B., Ginzburg L., Oppenheimer G. D. Regional ileitis; a pathologic and clinical entity. Am J Med. 1952;13(5):583-590. doi: 10.1016/0002-9343(52)90025-9.

4. Fedulova E.N., Zhukova E. A., Fedorova O. V., et al. Algorithm for the differential diagnosis of ulcerative colitis and Crohn’s disease in children at different stages of medical care (based on the mathematical assessment of clinical and anamnestic and laboratory and instrumental data).Russian medical Inquiry. 2014:22(11):848-853. (In Russ.)@@ Федулова Э. Н., Жукова Е. А., Федорова О. В. и др. Алгоритм дифференциальной диагностики язвенного колита и болезни Крона у детей на разных этапах медицинской помощи (на основе математической оценки клинико-анамнестических и лабораторно-инструментальных данных). РМЖ. 2014:22(11):848-853.

5. Gubergrits N.B., Lukashevich G. M., Golubova O. A., Fomenko P. G. [Pancreatitis in intestinal diseases]. Eksp Klin Gastroenterol. 2010;(8):27-34. (In Russ.) PMID: 21268323.@@ Губергриц Н. Б., Лукашевич Г. М., Голубова О. А. и др. Панкреатит при заболеваниях кишечника. Экспериментальная и клиническая гастроэнтерология. 2010;(8):27-34.

6. Barthet M., Lesavre N., Desplats S. et al. Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease. Pancreatology. 2006;6(5):464-471. doi: 10.1159/000094564.

7. Zamboni G., Lüttges J., Capelli P. et al. Histopathological features of diagnostic and clinical relevance in autoimmune pancreatitis: a study on 53 resection specimens and 9 biopsy specimens. Virchows Arch. 2004;445(6):552-563. doi: 10.1007/s00428-004-1140-z.

8. Maev I. V., Curly Yu. A. Diseases of the pancreas. In 2 vols. Moscow. JSC Publishing House “Medicine”, publishing house “Shiko”. 2008. 976 p. (In Russ.)@@ Маев И. В., Кучерявый Ю. А. Болезни поджелудочной железы. В 2 т. М.: ОАО Изд-во «Медицина», изд-во «Шико»; 2008. 976 с.

9. Okhlobystin A.V., Kucheryavy Yu. A. Recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of chronic pancreatitis (Draft). Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 2013;23(1):66-87. (In Russ.)@@ Охлобыстин А. В., Кучерявый Ю. А. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению хронического панкреатита (Проект). Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2013;23(1):66-87.

10. Ivashkin V.T., Shifrin O. S., Sokolina I. A. Chronic pancreatitis and pancreatic steatosis. Moscow. Litterra. 2012. 128 p. (In Russ.)@@ Ивашкин В. Т., Шифрин О. С., Соколина И. А. Хронический панкреатит и стеатоз поджелудочной железы. Москва: Литтерра; 2012. 128 с.

11. Bornman P.C., Botha J. F., Ramos J. M. et al. Guideline for the diagnosis and treatment of chronic pancreatitis. S Afr Med J. 2010;100(12 Pt 2):845-860. doi: 10.7196/samj.4530.

12. Frulloni L., Falconi M., Gabbrielli A. et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42 Suppl 6: S381-S406. doi:10.1016/S1590-8658(10)60682-2.

13. Lankisch P. G. Diagnosis of chronic pancreatitis. Lancet. 1998; 351(9102):599-600. doi: 10.1016/S0140-6736(05)78589-5.

14. Mortele K.J., Rocha V. C., Streeter J. L. Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics. 2006;26(3):715-731. doi: 10.1148/rg.263055164.

15. Badea R., Diaconu B. Contribution of ultrasound to the diagnosis of chronic pancreatitis and to evaluating its main complications. Rom J Gastroenterol. 2005;14(2):183-189. PMID: 15990941

16. Kim D.H., Pickhardt P. J. Radiologic assessment of acute and chronic pancreatitis. Surg Clin North Am. 2007;87(6):1341-viii. doi: 10.1016/j.suc.2007.08.0058.

17. Albashir S., Bronner M. P., Parsi M. A. et al. Endoscopic ultrasound, secretin endoscopic pancreatic function test, and histology: correlation in chronic pancreatitis. Am J Gastroenterol. 2010;105(11):2498-2503. doi: 10.1038/ajg.2010.274.

18. Kalra M.K., Maher M. M., Sahani D. V. et al. Current status of imaging in pancreatic diseases. J Comput Assist Tomogr. 2002;26(5):661-675. doi: 10.1097/00004728-200209000-00001.

19. Iglesias-García J., Lariño-Noia J., Lindkvist B. et al. Endoscopic ultrasound in the diagnosis of chronic pancreatitis. Rev Esp Enferm Dig. 2015;107(4):221-228. PMID: 25824921.

20. Kahl S., Glasbrenner B., Leodolter A. et al. EUS in the diagnosis of early chronic pancreatitis: a prospective follow-up study. Gastrointest Endosc. 2002;55(4):507-511. doi: 10.1067/mge.2002.122610.

21. Catalano M.F., Sahai A., Levy M. et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69(7):1251-1261. doi: 10.1016/j.gie.2008.07.04.

22. Wiersema M.J., Hawes R. H., Lehman G. A. et al. Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy. 1993;25(9):555-564. doi: 10.1055/s-2007-1010405.

23. Vavricka S.R., Schoepfer A., Scharl M. et al. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015;21(8):1982-1992. doi: 10.1097/MIB.0000000000000392.

24. Ramos L.R., Sachar D. B., DiMaio C.J. et al. Inflammatory Bowel Disease and Pancreatitis: A Review. J Crohns Colitis. 2016;10(1):95-104. doi: 10.1093/ecco-jcc/jjv153.

25. Akhmedov V.A., Gaus O. V. Pancreatic damage and inflammatory bowel disease: a random or natural combination? Terapevticheskiy arkhiv. 2020;92(1):76-81. (In Russ.)@@ Ахмедов В. А., Гаус О. В. Поражение поджелудочной железы и воспалительные заболевания кишечника: случайное или закономерное сочетание? Терапевтический архив. 2020;92(1):76-81.

26. Chen Y.L., Hsu C. W., Cheng C. C. et al. Increased subsequent risk of inflammatory bowel disease association in patients with chronic pancreatitis: a nationwide population-based cohort study. Curr Med Res Opin. 2017;33(6):1077-1082. doi: 10.1080/03007995.2017.1300143.

27. Barthet M., Hastier P., Bernard J. P. et al. Chronic pancreatitis and inflammatory bowel disease: true or coincidental association? Am J Gastroenterol. 1999;94(8):2141-2148. doi: 10.1111/j.1572-0241.1999.01287.x.

28. Oishi Y., Yao T., Matsui T. et al. Abnormal pancreatic imaging in Crohn’s disease: prevalence and clinical features. J Gastroenterol. 2004;39:26-33. doi: 10.1007/s00535-003-1241-5.

29. Heikius B., Niemelä S., Lehtola J. et al. Pancreatic duct abnormalities and pancreatic function in patients with chronic inflammatory bowel disease. Scand J Gastroenterol. 1996;31(5):517-523. doi: 1010.3109/00365529609006775.

30. Raimondo M., Wallace M. B. Diagnosis of early chronic pancreatitis by endoscopic ultrasound. Are we there yet? JOP. 2004;5(1):1-7. PMID: 14730117.


Review

For citations:


Budzinskaya A.A., Belousova E.A., Vakurova E.S., Lomakina E.U. Endosonographic changes of the pancreas in patients with inflammatory bowel diseases and chronic pancreatitis. Experimental and Clinical Gastroenterology. 2023;(5):73-80. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-213-5-73-80

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