Chronic pancreatitis other imaging findings
Chronic pancreatitis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
American Pancreatic Association Practice Guidelines |
Chronic pancreatitis other imaging findings On the Web |
American Roentgen Ray Society Images of Chronic pancreatitis other imaging findings |
Risk calculators and risk factors for Chronic pancreatitis other imaging findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Other imaging findings
Other Imaging Findings
Other imaging findings may include:
MRCP:
- The diagnostic study of choice.
- Secretin-enhanced MRCP use has been increased recently for the early diagnosis of chronic pancreatitis.
- Findings suggestive of chronic pancreatitis may include:
- Calcifications
- Pancreatic duct obstruction
- It involves no radiation risk.
Endoscopic retrograde cholangiopancreatography (ERCP):
- ERCP is usually done when there is no evidence of
- Calcifications on imaging
- Steatorrhea
- Findings diagnostic of chronic pancreatitis may include:
- Beaded appearance of the main pancreatic duct
- Ectatic side branches from the main pancreatic duct
- According to Cambridge classification, patients are divided into 3 categories on the basis of ductal changes seen on ERCP[1][2]
Cambridge classification | Ductal changes seen on ERCP |
---|---|
Cambridge I | Equivocal changes |
Cambridge II | Mild to moderate changes |
Cambridge III | Considerable changes |
Endoscopic ultrasonography (EUS):
- EUS is equally sensitive to ERCP and pancreatic function testing but the procedure requires high skill and usually performed by a skilled gastroenterologist.
Pancreatic function tests:
(a) Direct tests:
- Used to assess pancreatic insufficiency in the early course of disease when patient has clinical symptoms but no radiologic findings
- Secretin stimulation test is considered the gold standard functional test for diagnosis of chronic pancreatitis. The observation that bi-carbonate production is impaired early in chronic pancreatitis has led to the rationale of use of this test in early stages of disease.
(b) Indirect tests:
- Used to assess the complications of chronic pancreatitis
- Not sensitive to assess pancreatic insufficiency in the early course of disease
References
- ↑ Bozkurt T, Braun U, Leferink S, Gilly G, Lux G (1994). "Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis". Gut. 35 (8): 1132–6. PMC 1375069. PMID 7523260.
- ↑ Axon AT, Classen M, Cotton PB, Cremer M, Freeny PC, Lees WR (1984). "Pancreatography in chronic pancreatitis: international definitions". Gut. 25 (10): 1107–12. PMC 1432537. PMID 6479687.
- ↑ 3.0 3.1 Ketwaroo G, Brown A, Young B, Kheraj R, Sawhney M, Mortele KJ, Najarian R, Tewani S, Dasilva D, Freedman S, Sheth S (2013). "Defining the accuracy of secretin pancreatic function testing in patients with suspected early chronic pancreatitis". Am. J. Gastroenterol. 108 (8): 1360–6. doi:10.1038/ajg.2013.148. PMC 5388854. PMID 23711627.