Saturday, May 5, 2007

An Overview


Lab Tests:

  1. Amylase (the pancreatic enzyme responsible for digesting carbohydrates) is the most common blood test for acute pancreatitis. It increases from 2 to 12 hours after the beginning of symptoms and peaks at 12 to 72 hours. It may rise to 5 to 10 times the normal level and will usually return to normal within a week. Amylase also may be monitored with chronic pancreatitis, it will often be moderately elevated until the cells that produce it are destroyed.
  2. Lipase (the enzyme that, along with bile from the liver, digests fats) increases in the blood within 4 to 8 hours of the beginning of an acute attack and peaks at 24 hours. It may rise to several times its normal level and remains elevated longer than amylase. As cells are destroyed with chronic pancreatitis and as lipase production drops to less than 10% of the normal level, steatorrhea (fatty, foul-smelling stools) will form.
  3. Trypsin (which digests proteins) is thought to be the most sensitive blood test for acute pancreatitis but is not widely available and not routinely used. Stool trypsin tests are used to check for pancreatic insufficiency and may be part of a work-up for chronic pancreatitis. Trypsinogen (Immunoreactive trypsin) is a blood test that may be used to check pancreatic sufficiency in those with chronic pancreatitis.

Other lab tests that may be used to check for complications of acute pancreatitis include:

  1. Complete Blood Count (CBC) (including white blood cell count)
  2. Comprehensive Metabolic Panel (Bilirubin, liver function tests)
  3. Glucose
  4. Calcium
  5. Magnesium
  6. C-Reactive Protein
Other lab tests that may be used to check for chronic pancreatitis include:

  1. Fecal fat
  2. Trypsin
  3. Trypsinogen (Immunoreactive trypsin)

Non-laboratory tests may include:

  1. Abdominal ultrasound
  2. ERCP (endoscopic retrograde cholangiopancreatography), a flexible scope used to see and sometimes remove gallstones
  3. EUS Endoscopic Ultrasound
  4. EGD (Upper EndoscopyEsophagogastroduodenoscopy)
  5. CT (computed tomography) scan
  6. Secretin testing (not widely available) in which a tube is positioned in the duodenum to collect pancreatic secretions stimulated by IV secretin
  7. MRI (magnetic resonance imaging)
  8. MRCP
  9. Percutaneous Transhepatic Cholangiography (PTC)
  10. Wireless Capsule Endoscopy - "The Camera in a Pill"
  11. Barium Exrays
  12. Ultrasound
  13. Nuclear Scans
  14. Hemoccult Card Test

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