Rational sequence of tests for pancreatic function.
Of 144 patients with suspected pancreatic disease in whom a 75Se-selenomethionine scan was performed, endoscopic retrograde pancreatography (ERP) was successful in 108 (75%). The final diagnosis is known in 100 patients and has been compared with scan and ERP findings. A normal scan reliably indicated a normal pancreas, but the scan was falsely abnormal in 30%. ERP distinguished between carcinoma and chronic pancreatitis in 84% of cases but was falsely normal in five patients with pancreatic disease. In extrahepatic biliary disease both tests tended to give falsely abnormal results. A sequence of tests to provide a rapid and reliable assessment of pancreatic function should be a radio-isotope scan, followed by ERP if the results of the scan are abnormal, and a Lundh test if the scan is abnormal but the findings on ERP are normal.
D000208:Acute Disease; D001660:Biliary Tract Diseases / Q000175:diagnosis; D002908:Chronic Disease; D004724:Endoscopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D011859:Radiography; D011877:Radionuclide Imaging