Does aging influence pancreatic response in the ultrasound secretin test by impairing hydrokinetic exocrine function or sphincter of Oddi motor function?
BACKGROUND
Secretin administration induces a brief distinct dilatation of the main pancreatic duct in healthy persons, visible at ultrasonography. Several investigations have indicated that sonographic duct measurements before and after secretin injections are a useful tool in the diagnostic screening for pancreatic disease.


OBJECTIVE
Aim of this study was to evaluate the influence of aging on the test results.


METHODS
We examined prospectively two groups of patients with distinctly different mean age, measuring the pancreatic duct diameter sonographically before, 2, 4, 6 and 10 minutes after intravenous injection of 1 CU secretin per kilogram body weight. The examination was performed in all patients on account of abdominal complaints, and pancreatic disease could be excluded by further diagnostic procedures. Group 1 consisted of 22 patients, median age 30.5 years, Group 2: 21 patients, median age 68 years.


RESULTS
The younger patients (Group 1) had a mean basal pancreatic duct diameter of 1.6 mm. After secretin injection they showed dilatation reading 3. 1 mm, corresponding to 94% of the basal duct diameter. The older patients (Group 2), with a basal diameter of 1.9 mm, showed a duct enlargement of about 84% to 3.5 mm. There was no statistically significant difference between the two groups concerning extent and temporal development of secretin-induced pancreatic duct dilatation.


CONCLUSIONS
The underlying mechanisms of response to secretin stimulation - hydrokinetic pancreatic function, sphincter of Oddi motor function, and extensibility of Wirsung's duct--do not seem to be impaired by aging. Thus, the ultrasound secretin test should be suitable for application in older patients.
Glaser
J
J
Department of Internal Medicine and Gastroenterology, General District Hospital Fulda, Germany. dialog@herz-jesu-krankenhaus.de
Stienecker
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D001657:Biliary Dyskinesia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000187:drug effects; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D012633:Secretin / Q000008:administration & dosage; D012720:Severity of Illness Index; D009803:Sphincter of Oddi / Q000187:drug effects / Q000502:physiology*; D014463:Ultrasonography
D012633:Secretin