Screening for Pancreatic Disease

Abstract

In 88 cases of confirmed chronic pancreatic disease a group of simple tests were studied as to their value in the detection of pancreatic disease. The tests evaluated were: 1) serial serum diastases, 2) 24-hour urine diastases, 3) a glucose tolerance test or blood sugar 2 hours after 100 g. of glucose by mouth, and 4) a provocative serum enzyme test. The serial serum diastase was abnormal in 83% of the cases studied. Twenty-four patients had low values and 48 had high values. Urinary diastase values were abnormal in 56% of cases in which the test was performed. In four cases the serum levels were non diagnostic but the urine value was high. The provocative serum test was abnormal in 45% and the glucose tolerance test was abnormal in 58% of the patients. An inverse relationship was noted between the provocative serum enzyme test and glucose tolerance test and the pathophysiologic basis for this observation was discussed. If all tests were used the profile was more sensitive in detecting pancreatic disease than if only three tests were used.