Chronic pancreatitis diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Overview

The diagnostic study of choice for chronic pancreatitis is magnetic resonance cholangiopancreatography (MRCP). The diagnosis is difficult to establish because the laboratory results and the imaging may be normal. Diagnostic findings confirmatory for chronic pancreatitis may include pancreatic calcifications seen on abdominal plain films or CT scan, beaded appearance of main pancreatic duct seen on pancreatogram. Abnormal pancreatogram shows ectatic side branches from the main pancreatic duct and abnormal pancreatic function tests (Secretin stimulation test).

Diagnostic Study of Choice

Gold standard or study of choice:

• The diagnostic study of choice for chronic pancreatitis is magnetic resonance cholangiopancreatography (MRCP) because:
  • It may help in the detailed assessment of the ductal changes.
  • It eliminates the need to perform endoscopic retrograde cholangiopancreatography (ERCP).

Diagnostic Criteria

• The diagnosis is difficult to establish as the laboratory results and the imaging may be normal.

Diagnostic findings suggestive of chronic pancreatitis:

Diagnostic findings suggestive of chronic pancreatitis include the triad of:

• Pancreatic calcifications
• Steatorrhea
• Diabetes mellitus

Diagnostic findings confirmatory for Chronic pancreatitis:

Diagnostic findings confirmatory for chronic pancreatitis may include

• Pancreatic calcifications seen on abdominal plain films or CT scan
• Beaded appearance of main pancreatic duct seen on pancreatogram
• Abnormal pancreatogram showing ectatic side branches from the main pancreatic duct
• Abnormal pancreatic function tests (Secretin test)

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