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The Combined Study of Serum Enzymes and Duodenal Contents in the Diagnosis of Pancreatic Disease

1960; Elsevier BV; Volume: 38; Issue: 4 Linguagem: Inglês

10.1016/s0016-5085(60)80030-3

1528-0012

David C. H. Sun, Harry Shay,

Liver Disease Diagnosis and Treatment

Summary 1.A combined study of the serum amylase and lipase activities and of volume, bicarbonate, and amylase activity of the duodenal contents after pancreozyminsecretin stimulation is described. Pancreozymin was given first, followed in 10 minutes by secretin, intravenously. 2.Pancreozymin-secretin test gave positive serum enzyme responses in 9 of 18 patients with chronic pancreatitis, in all of 3 cases of carcinoma of the ampulla of Vater, and in only one of 5 cases of carcinoma of the pancreas. A comparative study of pancreozymin and secretin and of secretin alone as the stimulant in some of these patients showed that the addition of pancreozymin increased the yield of positive serum enzyme responses. 3.Five of the 9 cases of chronic pancreatic disease with positive serum enzyme responses showed normal findings of the duodenal contents. On the other hand, the other 9 cases with normal serum enzyme response showed low values of the duodenal contents. 4.We recommend that in cases of suspected pancreatic disease, the provocative serum enzyme test with pancreozymin and secretin be done first; if negative, to be followed by a duodenal intubation study. The provocative serum enzyme test could be included as one of the tests in the routine investigation of chronic pancreatic disease.