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World J Gastrointest Endosc. 2013 May 16;5(5):251-4. doi: 10.4253/wjge.v5.i5.251.

Endoscopic ultrasonography in patients with elevated carbohydrate antigen 19-9 of obscure origin.

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Jae Hoon Cheong, Gwang Ha Kim, Ji Yoon Moon, Bong Eun Lee, Dong Yup Ryu, Dong Uk Kim, Geun Am Song, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, South Korea.



To evaluate the efficacy of endoscopic ultrasonography (EUS) in patients with elevated carbohydrate antigen (CA) 19-9 levels of obscure origin.


Patients who had visited Pusan National University Hospital because of elevated serum CA 19-9 levels, between January 2007 and December 2009, were retrospectively enrolled. EUS had been performed on all subjects, in addition to routine blood tests, endoscopy, abdominal computed tomography (CT) and other clinical exams, which had not revealed any abnormal findings suggestive of the origin of the elevated CA 19-9 levels.


Of the 17 patients, gallbladder sludge was detected in 16 patients (94.1%) and common bile duct sludge was observed in 3 patients (17.6%). After the administration of ursodeoxycholic acid to 12 of the patients with gallbladder sludge, CA 19-9 levels normalized in 6 of the patients after a median of 4.5 mo.


EUS is a useful diagnostic method for patients with elevated CA 19-9 levels of obscure origin, even if the reason for abnormal levels of this serum marker cannot be determined through prior examinations, including abdominal CT.


Carbohydrate antigen 19-9; Endoscopic ultrasonography; Gallbladder; Ursodeoxycholic acid

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