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Old 04-22-2016
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Warning! CONFUSED best initial, accurate tests for pancreatitis? HELP PLEASEEEEEE

hey guys!

I'm working with MTB2 and i am very much confused about the best initial and accurate tests for diseases concerning the pancreas

like: acute pancreatitis, chronic pancreatitis, pancreatic cancer

my understanding so far for acute pancreatitis is:

best initial:ct abdomen preferred over x-ray of abdomen
accurate:secretin stimulation testing

i am reading elsewhere that for accurate testing, ERCP is preferred

would appreciate any info regarding this and also for chronic pancreatitis and pan. cancer as well!

thanks in advance!
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Old 04-22-2016
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Originally Posted by Virgo11 View Post
hey guys!

I'm working with MTB2 and i am very much confused about the best initial and accurate tests for diseases concerning the pancreas

like: acute pancreatitis, chronic pancreatitis, pancreatic cancer

my understanding so far for acute pancreatitis is:

best initial:ct abdomen preferred over x-ray of abdomen
accurate:secretin stimulation testing

i am reading elsewhere that for accurate testing, ERCP is preferred

would appreciate any info regarding this and also for chronic pancreatitis and pan. cancer as well!

thanks in advance!
For acute pancreatitis, Sx of severe epigastric pain radiating to the back associated with nausea/vomiting + serum amylase/lipase 3 times the upper limit of normal is sufficient to make the Dx. If features are atypical or serum amylase/lipase not elevated 3x upper limit of normal, then CT scan abdomen is diagnositic. Secretic stimulation test has no role in Dx

For pancreatic cancer, patients who present with Sx of epigastric pain, obstructive jaundice, weight loss, first test would be an USG to look for dilated biliary/pancreatic ducts. If an US does not show it, do ERCP which best identified dilated ducts. If there is no obstructive jaundice but features suggestive of pancreatic cancer, do CT scan abdomen. EUS (endoscopic US) has a role in extent of disease.

For chronic pancreatitis, traid of pancreatic calcifications, steatorrhea and DM is dx. Start with plain abdominal X-ray to look for calcifications, follow with CT scan if the X rat fails to show it. ERCP will show abnormal dilated bead like appeareance of pacncreatic ducts. Pancreatic function test (secretic function, stool for elastase) or EUS in patients with normal imagine with still suspicion for chronic pancreatits.
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Old 04-22-2016
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