EOSINOPHILIC PANCREATITIS MIMICKING PANCREATIC NEOPLASIA - EUS AND ERCP FINDINGS - IS NONSURGICAL DIAGNOSIS POSSIBLE

Eosinophilic pancreatitis is a rare disease with, to date, only 10 rep orted cases. We report two patients whose presentation was suggestive of a pancreatic tumor. An 18-year old man presented with a short histo ry of obstructive jaundice, epigastric pain, and weight loss. Endoscop ic ultrasonography revealed a 12-mm round, hypoechoic lesion in the he ad of the pancreas, suggestive of a pancreatic endocrine tumor. A duod enopancreatectomy was performed, and the patient made an uneventful re covery. A 64-year-old man was referred with weight loss and obstructiv e jaundice due to a stricture of the common bile duct. Retrograde panc reatography demonstrated a very narrow, regular main pancreatic duct a nd early parenchymography. Endoscopic retrograde cholangiopancreatogra phy revealed a tight, regular stenosis of the intrahepatic portion of the common bile duct. A gastrojejunal anastomosis and biliary-digestiv e bypass were performed without postoperative complications. In both c ases, the diagnosis of eosinophilic pancreatitis was revealed after su rgical resection. The features of eosinophilic pancreatitis, including eosinophilic infiltration of the digestive wall, a history of atopy, and the radiological characteristics are described. If these are of su fficient discriminatory value, unnecessary surgery may be avoided.