Rational sequence of tests for pancreatic function.
Br Med J 1976; 2 doi: https://doi.org/10.1136/bmj.2.6047.1307 (Published 27 November 1976) Cite this as: Br Med J 1976;2:1307- C J Mitchell,
- E Elias,
- J E Agnew,
- J Summerfield,
- R Dick
Abstract
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.