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Pancreatitis

What is it? | Signs and Symptoms? | Tests | Prevention & Treatment | Related Pages

Tests

  • Amylase (the pancreatic enzyme responsible for digesting carbohydrates) is the most common blood test for acute pancreatitis. It increases from 2 to 12 hours after the beginning of symptoms and peaks at 12 to 72 hours. It may rise to 5 to 10 times the normal level and will usually return to normal within a week. Amylase also may be monitored in chronic pancreatitis.  It is often moderately elevated until the cells that produce it are destroyed.
  • Lipase (the enzyme that, along with bile from the liver, digests fats) increases in the blood within 4 to 8 hours of the beginning of an acute attack and peaks at 24 hours. It may rise to several times its normal level and remains elevated longer than amylase. As cells are destroyed in chronic pancreatitis and as lipase production drops to less than 10% of the normal level, steatorrhoea (fatty, foul-smelling stools) will result.
  • An increase in plasma alanine aminotransferase (ALT) and jaundice suggest gall stones are the cause of acute pancreatitis. If the cause is not clear, plasma triglycerides and calcium should be measured.
  • Stool chymotrypsin tests can be used to exclude pancreatic insufficiency. Immunoreactive trypsin (IRT) is a blood test that may be used to check pancreatic sufficiency in those with chronic pancreatitis. Nowadays faecal fat is rarely used to check for pancreatic sufficiency.

    • Other tests that may be used to check for complications of acute pancreatitis include:

  • Full Blood Count (including white blood cell count)
  • Glucose

    • Non-laboratory tests may include:

  • Abdominal ultrasound
  • ERCP (endoscopic retrograde cholangiopancreatography), a flexible scope used to see and sometimes remove gallstones
  • CT (computed tomography) scan to look for calcified ducts in chronic pancreatitis
  • Secretin testing (rarely used) in which a tube is positioned in the duodenum to collect pancreatic secretions stimulated by injection of the hormone secretin into a vein
  • MRI (magnetic resonance imaging)

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