The Pancreatitis Supporters' Network
The Pancreatitis Supporters' Network
Email psn@pancreatitis.org.uk
you are here: About Pancreatitis
The pancreas is a spongy, tube-shaped organ about 6 inches long. It is located in the back of the abdomen, behind the stomach. The head of the pancreas is on the right side of the abdomen. It is connected to the duodenum, the upper end of the small intestine. The narrow end of the pancreas, called the tail, extends to the left side of the body.
The pancreas makes pancreatic juices and hormones, including insulin. Pancreatic juices, also called enzymes, help digest food in the small intestine. Insulin controls the amount of sugar in the blood. Both enzymes and hormones are needed to keep the body working right.
As pancreatic juices are made, they flow into the main pancreatic duct. This duct joins the common bile duct, which connects the pancreas to the liver and the gallbladder. The common bile duct, which carries bile (a fluid that helps digest fat), connects to the small intestine near the stomach.
ULTRASONOGRAPHY OR ULTRASOUND (US) SCAN:
This is a simple, painless and relatively quick investigation which can be used to obtain a picture of the inside of the abdomen.
COMPUTERISED TOMOGRAPHY (CT SCAN)
This is more complex and time consuming than an ultrasound scan but produces excellent pictures of the pancreas and other abdominal structures.
NEEDLE BIOPSY OR CYTOLOGY USING ULTRASOUND OR CT SCAN
Occasionally a small piece of tissue from the pancreas needs to be taken to help make a diagnosis.
ENDOLUMINAL ULTRASOUND (EUS)
This is a special investigation for taking ultrasound pictures of the pancreas, pancreatic and bile ducts and surrounding tissue such as blood vessels. The pictures are taken by a special probe inserted into the stomach and duodenum.
ERCP
This is a special investigation for taking pictures of the bile and pancreatic ducts and is mainly used for treatment of bile duct and pancreatic duct problems. The full name of ERCP is rather a mouthful: endoscopic retrograde cholangio-pancreatography! Sometimes it is necessary to insert a temporary (plastic) or permanent (metal mesh) tube into the bile duct to keep a good flow of bile. These tubes are called stents after Dr Stent who first used these small tubes.Stents or temporary tubes (also called a cannula) may also be inserted into the main pancreatic duct.
ERCP must be:
Performed
by a specialist.
An
MRI scan
is similar to a CT scan but uses magnetic resonance to
image the pancreas instead of X-rays. Very powerful
magnets are used to generate the pictures. For this reason patients that have
certain metal parts inside their bodies (that can respond to the magnet) must
not have this procedure. Most modern appliances introduced into patients, such
as clips
during open surgery or a heart
valve with metal parts, are made of material which cannot respond to the magnet
and are therefore safe. As a precaution you must tell your doctors if you have
any such appliances in your body to let them decide.
PET Scan
This is a special scan performed in the Nuclear Medicine Department and is sometimes performed in certain centres if there is uncertainty as to the diagnosis. In other words this is performed if the doctors are not sure if you have chronic pancreatitis or a small pancreatic cancer. The full term or a PET scan is Positron Emission Tomography.
SPECIAL TESTS FOR PANCREATIC FUNCTION IN PANCREATITIS
TESTS FOR DIABETES
The urine can be tested for glucose using a simple technique of dipping a special strip of paper into a urine sample.
More precise tests involve measuring the actual glucose level in the blood by taking a blood sample from an arm vein. A patient who is thought to be developing diabetes can be tested by a glucose tolerance test. This involves taking a glucose drink following an overnight fast and then measuring the blood glucose level from blood samples taken over the next 2-3 hours.
TESTS FOR PANCREATIC ENZYME PRODUCTION
Faecal Elastase Test
Elastase is one of the enzymes produced by the pancreas to digest protein. There is always a small extra amount produced which means that it can be measured in the stool.
PLT or Pancreato-Lauryl Test
A standard meal is taken following an overnight fast along with a test food (with PLT). One or more blood tests or a urine test is then made to see if the test food has been digested (by the pancreatic enzymes) and then absorbed.
Triolein breath test
This is a more specific test for fat digestion and absorption and is fairly simple to perform.
Faecal fat test
This is an excellent way of determining fat digestion but involves collecting stools for 1-3 days.
Secretin test
This is performed in only a few very specialist pancreas units and is very accurate (like the faecal fat test).
MUCH more information than here can be read in the downloadable booklets on
you are here: About Pancreatitis
