Diagnostic studies-chronic pancreatitis

(Pancreas 2014;43:1143; Am J Gastro 2020;115:322)

• Labs:

  • amylase/lipase ↑ early,
  • may be nl later. ⊕ fecal fat,
  • ↓ stool elastase & A1AT.
  • Mixed TG breath test alternative to stool elastase.
  • ✓A1c,
  • consider IgG4/ANA & genetic testing if young or ⊕ FHx.
  • If dx w/ CP,
    • measure baseline fat-soluble vitamins (ADEK).

• Imaging: Ca2+ on KUB/CT. ERCP/MRCP/EUS: high sens for dx; may show stricture, dilated ducts. IV secretin stim w/ MRI may ↑ dx yield. Panc fxn testing not widely available.