Endoscopic ultrasound in chronic pancreatitis: Where are we now?

Figure 1 Flowchart of the endoscopic ultrasonography utility in chronic pancreatitis. EUS: Endoscopic ultrasonography; CP: Chronic pancreatitis; CE-EUS: Contrast enhanced endoscopic ultrasonography; MPD: Main pancreatic duct.

Figure 2 Chronic pancreatitis. Parenchymal and ductal pancreatic stones as hyperechoic structures with shadowing and stenosis of the main pancreatic duct.

Figure 3 Mass resembling chronic pancreatitis. A: Conventional endoscopic ultrasonography (EUS). Hypoechoic inhomogeneous mass in the pancreatic head. Aorta and inferior caval vein are also seen; B: Contrast-enhanced harmonic-EUS. During the arterial phase (25 s after contrast injection) the abdominal aorta becomes hyperechoic and the mass is hypovascular compared with surrounding parenchyma.

Figure 4 Endoscopic ultrasonography-guided pseudocyst drainage. A: The cystostomy is seen as a hyperechoic parallel structure inside the hypoechoic well-delineated pseudocyst; B: Endoscopic view of a stent and a nasocystic drainage placed transgastric into a pseudocyst.