A new direct pancreatic function test in pediatrics.
Traditional methods for collecting duodenal fluid are time consuming and technically difficult. A simple endoscopic method is proposed in this report as a means of collecting duodenal fluid to perform exocrine pancreatic function tests. Thirty-five patients between 24 and 36 months of age were studied for pancreatic exocrine function. Twenty-seven presented with chronic diarrhea and 8 with failure to thrive. In 20 patients (group 1), duodenal fluid was collected by means of a double-lumen tube and sequential administration of pancreozymin (PZN) and secretin (SEC). The rest (group 2) had duodenal aspiration from the level of the papilla of Vater through a fiberoptic endoscope following administration of SEC only. The procedure took approximately 3 h in group 1 and 45 min in group 2. Secretin administration produced comparable levels of enzymes in both groups. Pancreozymin produced the highest enzyme levels, but this was only significantly higher than SEC-induced levels in the case of lipase. Endoscopic collection of duodenal fluid following SEC administration is a safe, quick, and reliable method of collecting pancreatic secretion.
Madrazo-de la Garza
J A
JA
Department of Pediatrics, Hahnemann University, Philadelphia, Pennsylvania 19101-1192.
Gotthold
M
M
Lu
R B
RB
Hill
I D
ID
Lebenthal
E
E
D002675:Child, Preschool; D002766:Cholecystokinin; D004386:Duodenum / Q000201:enzymology; D004724:Endoscopy; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis; D005336:Fiber Optic Technology; D006801:Humans; D007419:Intestinal Secretions / Q000737:chemistry; D008297:Male; D010186:Pancreatic Function Tests / Q000379:methods* / Q000592:standards; D010372:Pediatrics; D012633:Secretin; D013396:Suction
D012633:Secretin; D002766:Cholecystokinin