Acute pancreatitis is an acute inflammatory process of the pancreas and a leading cause of hospitalization. Diagnosis of acute pancreatitis is typically based on clinical history, laboratory examination, and imaging. The most important causes are alcohol, gallstones, hyperlipidemia, hypercalcemia, and drugs.However, the etiology remains unclear in approximately 10% to 30% of patients, classified as acute idiopathic pancreatitis. Endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP/MRI) can be diagnosing the underlying cause of pancreatitis. This study aimed to investigate the results of EUS and MRCP/MRI in patients with acute idiopathic pancreatitis.

Hospitalized patients diagnosed with acute idiopathic pancreatitis were investigated. For all these patients, liver and gallbladder ultrasound, blood sugar, triglyceride, calcium and phosphorus tests were performed, which were normal, and the history of alcohol consumption and certain drugs and herbal use were also asked, which were negative. All these patients were examined by endosonography and some of them were examined by MRCP.

The primary patients diagnosed with acute pancreatitis were 101. Out of this number, the information of 71 patients was complete and they were included in the study. The average age of the patients was 46.3 ± 15.2 years. Majority of the patients were females (46 female, 64.8%). Among the participants, 22 individuals had a history of recurrent pancreatitis (31.4%), 43 patients had previously been hospitalized for pancreatitis (60.6%), and 19 patients had undergone cholecystectomy(26.6%). The results of endosonography findings in patients are shown in Table 1 MRCP was performed on 17 patients .In 10 out of 26 patients with normal endosonography, MRCP was also normal. Among 13 cases showing sugestive chronic pancreatitis or suspected pancreatobiliary junction anomaly or no diagnostic in EUS, MRCP was carried out in 7 patients, revealing suspected chronic pancreatitis in 3 instances, non-diagnostic and in two patient and normal in two patients. Table 1 EUS finding N (%) Normal EUS 26 (36.6%) Diagnostic Findings 41 (57.7%) Gallstone* 15(21.1%) Common bile duct stone 9(12.6%) Consistent with chronic pancreatitis** 8(11.2%) Suggestive for chronic pancreatitis** 8(11.2%) chollangiocarcinoma 2(2.8%) Anomaly of pancreatobiliary junction 1(1.4%) Abnormal but non diagnostic 4(5.6%)

Endosonography can be very helpful in diagnosing the etiology of patients with acute pancreatitis with unknown etiology.