Principles of diagnosis of chronic pancreatitis
Diagnosis of chronic pancreatitis is based on three " pillars».
The first is a carefully collected medical history (medical biography of the patient with information about the living conditions that preceded the disease).
The second is to identify the features of the clinical picture of the disease.
The third is the analysis of laboratory and instrumental studies.
1. from laboratory tests, first of all, blood parameters are taken into account. The development of anemia, increased leukocyte count (leukocytosis) and an accelerated ESR (the erythrocyte sedimentation rate in crow) indicate severe forms of the disease.
2. Complete the picture of the study of the activity of enzymes: amylase in blood serum and urine, as well as trypsin and lipase in pancreatic juice. (The juice is extracted by duodenal probing.)
Determining the activity of enzymes allows you to assess the functional state of the pancreas. The content of the enzyme in the blood increases with the exacerbation of pancreatitis or as a result of the development of a pathological process that violates the unhindered outflow of pancreatic juice. These processes include: inflammatory edema of the head of the gland and compression of the ducts, scarring of the large papilla of the duodenum.
3. The study of feces is also important. The increased content of undigested food in the feces indicates a significant decrease in the external secretory function of the gland. It is believed that a large amount of neutral fat and muscle fibers in the excrement indicates a 90% loss of external secretion of the gland.
4. Very valuable information is provided by x-rays, ultrasound echolocation, radioisotope scanning, CT and angiography.