Diagnosing Chronic Pancreatitis

摘要: Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive patients early changes CP. The workup of suspected should follow a progressively noninvasive more invasive STEP-wise approach patient suspicious clinical presentation risk factors that raise their pretest probability disease. After thorough history physical examination, basic laboratories be obtained such as lipase, amylase, metabolic panel, indirect PFTs (fecal elastase-1, serum trypsin). Computed tomography remains the best initial modality obtain it has good sensitivity for may obviate need other diagnostic tests. When equivocal, an MRCP detailed evaluation both pancreatic parenchyma ducts. If diagnosis doubt, EUS performed or without pancreas function testing. ERCP last-line test seldom used outside therapeutic purposes. Future advances target optimizing current tools accurately diagnose CP, is this population where benefits delaying progression have most profound effect. Likely way at establishing these via testing setting indeterminate results. Biomarker studies fluid supplement diagnosis.