Video
EUS detection of a small pancreatic mass not detected by CT or MRI imaging
125.1 This video illustrates an EUS exam showing a small pancreatic head lesion just above the ampulla in a patient who developed jaundice and underwent ERCP with biliary stenting. Brushings at the time of ERCP were negative, and the cholangiogram showed a focal intrapancreatic bile duct stricture just proximal to the ampulla. The initial portion of the EUS video shows a CBD stent in the center of the screen that appears to have migrated distally so that its proximal portion is within the hypoechoic mass, not above it. Further imaging on the right side of the video shows CBD dilation above the mass, in contrast with a non-dilated CBD with an intraluminal stent seen distal to the mass. The dilated CBD is next to the portal vein, which is highlighted by the use of color flow imaging. The EUS-identified mass measures 2.3 x 2.5 cm and was not visualized on prior CT or MRI imaging. Subsequent EUS-guided FNA confirmed the presence of a pancreatic adenocarcinoma.
