Abstract
The secretin-pancreozymin (SP) and Lundh-Borgström (meal) tests were compared in diagnosing chronic pancreatitis (CP). A range of normal values for each test was obtained in a control group of 22 patients without pancreatic disease. Seventeen patients with CP were given the tests on separate days. The peak concentration of bicarbonate after secretin was reduced in 14 of these 17 patients, post-secretin bicarbonate output fell in 13, while peak tryptic activity (PTA) in duodenal juice after pancreozymin was below normal in 10; the overall incidence of abnormal results in SP tests was 88%. The mean tryptic activity (MTA) in a two-hour collection of duodenal juice after the test meal was reduced below normal in 16 of the 17 patients.
In the control group PTA after pancreozymin was closely similar to MTA after the test meal, but in the patients with CP MTA was significantly less than PTA. PTA and MTA correlated significantly in both the control and CP groups, and the slopes of the two regression lines were not significantly different. In each patient with CP the tryptic response to the test meal was only a third of the tryptic response to intravenous pancreozymin. This disproportionate reduction in tryptic response to endogenous compared with exogenous stimulation in CP accounts for the high success rate of the meal test, which equalled the SP test.
The Lundh-Borgström test is a sensitive indicator of CP and is within the resources of most hospitals. The SP test is better suited to specialist centres and may provide valuable additional information in individual cases.
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Selected References
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- Fawcitt R. A., Forbes W. S., Isherwood I., Braganza J. M., Howat H. T. Computed tomography in pancreatic disease. Br J Radiol. 1978 Jan;51(601):1–4. doi: 10.1259/0007-1285-51-601-1. [DOI] [PubMed] [Google Scholar]
- Gyr K., Agrawal N. M., Felsenfeld O., Font R. G. Comparative study of secretin and Lundh tests. Am J Dig Dis. 1975 Jun;20(6):506–512. doi: 10.1007/BF01074934. [DOI] [PubMed] [Google Scholar]
- Hartley R. C., Gambill E. E., Engstrom G. W., Summerskill H. J. Pancreatic exocrine function. Comparison of responses to augmented secretin stimulus, augmented pancreozymin stimulus, and test meal in health and disease. Am J Dig Dis. 1966 Jan;11(1):27–39. doi: 10.1007/BF02237668. [DOI] [PubMed] [Google Scholar]
- James O. The Lundh test. Gut. 1973 Jul;14(7):582–591. doi: 10.1136/gut.14.7.582. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lurie B., Brom B., Bank S., Novis B., Marks I. N. Comparative response of exocrine pancreatic secretion following a test meal and secretin-pancreozymin stimulation. Scand J Gastroenterol. 1973;8(1):27–32. [PubMed] [Google Scholar]
- Moeller D. D., Dunn G. D., Klotz A. P. Comparison of the pancreozymin-secretin test and the Lundh test meal. Am J Dig Dis. 1972 Sep;17(9):799–805. doi: 10.1007/BF02231150. [DOI] [PubMed] [Google Scholar]
- SUN D. C. THE USE OF PANCREOZYMIN-SECRETIN TEST IN THE DIAGNOSIS OF PANCREATITIS AND TUMORS OF THE PANCREAS. Gastroenterology. 1963 Aug;45:203–208. [PubMed] [Google Scholar]
- Waller S. L. The Lundh test in the diagnosis of pancreatic disease: a comment from the moderator. Gut. 1975 Aug;16(8):657–658. doi: 10.1136/gut.16.8.657. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wormsley K. G. Tests of pancreatic function. Br J Clin Pract. 1970 Jul;24(7):271–275. [PubMed] [Google Scholar]
- Worning H. The pancreatic secretion of amylase as compared to the amylase concentration in the intestinal contents after ingestion of a meal. Scand J Gastroenterol. 1971;6(3):257–260. doi: 10.3109/00365527109180704. [DOI] [PubMed] [Google Scholar]
- Zieve L., Mulford B., McHale A. Secretion of pancreatic enzymes. II. Comparative response following test meal or injection of secretin and pancreozymin. Am J Dig Dis. 1966 Sep;11(9):685–694. doi: 10.1007/BF02239421. [DOI] [PubMed] [Google Scholar]