Parasites and Biliary stones

Endoscopic retrograde cholangiopancreatography ١٢٩
complex can be used to diagnose acute pancreatitis. The former is
measured at 6 hours, and the latter is measured at 24 hours; the sensitivity
of each is over 90% (Shimizu et al., 1999). Pancreatitis is also more
likely to develop in patients with contrast material visualized in the renal
collecting system on a plain radiograph obtained at the conclusion of the
procedure (Roszler et al., 1985).
Incidence:
The rates of pancreatitis after ERCP and sphincterotomy have
ranged from less than 1% to 40%. The wide variation between studies
likely reflects varying definitions, methods of data collection, patient
populations, indications for ERCP, types of procedures performed, and
endoscopic expertise (Gottlieb and Sherman, 1998).
Management of post-ERCP pancreatitis is: General guidelines for
performing CT include(a)Cases in which the clinical diagnosis is not
definite;(b)Patients with hyperamylasemia, severe clinical pancreatitis,
abdominal distention, tenderness, fever, or leukocytosis;(c)Patients whose
condition does not improve within 72 hours of commencing conservative
treatment; and(d)Patients who develop an acute change after initial
improvement in their condition (Simchuk et al., 2000)
Patients may have focal edema or diffuse glandular swelling in post-
ERCP inflammation (Kuhlman et al., 1989). Focal swelling of the
pancreatic head has been referred to as pancreatic pseudotumor and can
be seen after papillotomy (De Vries et al., 1997).