Chronic pancreatitis diagnostic study of choice: Difference between revisions

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VisualWikitext

Latest revision as of 20:56, 2 February 2018

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:

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)

References

Template:WikiDoc Sources

@@ Line 4: / Line 4: @@
 == Overview ==
-* The page name should be '''"Diagnostic study of choice for [disease name]"''', with only the first letter of the title capitalized. Note that the page is called "Diagnostic study of choice."
+The diagnostic study of choice for chronic pancreatitis is [[Magnetic resonance cholangiopancreatography|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]] [[Calcification|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).
-* '''Goal:'''
-**To describe the most efficient/sensitive/specific test that is utilized for diagnosis of [disease name].
-**To describe the gold standard test for the diagnosis of [disease name].
-**To describe the diagnostic criteria, which may be based on clinical findings, physical exam signs, pathological findings, lab findings, findings on imaging, or even findings that exclude other diseases.
-* As with all microchapter pages linking to the main page, at the top of the edit box put <nowiki>{{CMG}}</nowiki>, your name template, and the microchapter navigation template you created at the beginning.
-* Remember to create links within WikiDoc by placing <nowiki>[[square brackets]]</nowiki> around key words which you want to link to other pages. Make sure you makes your links as specific as possible. For example, if a sentence contained the phrase anterior spinal artery syndrome, the link should be to [[anterior spinal artery syndrome]] not [[anterior]] or [[artery]] or [[syndrome]].  For more information on how to create links, click [[here]].
-* Remember to follow the same format and capitalization of letters as outlined in the template below.
-* You should include the name of the disease in the first sentence of every subsection.
 == Diagnostic Study of Choice ==
-===== Template statements =====
+=== Gold standard or study of choice: ===
+*The diagnostic study of choice for chronic pancreatitis is [[Magnetic resonance cholangiopancreatography|magnetic resonance cholangiopancreatography (MRCP)]] because:
-=== Gold standard/Study of choice: ===
+**It may help in the detailed assessment of the ductal changes.
-* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
+**It eliminates the need to perform [[Endoscopic retrograde cholangiopancreatography|endoscopic retrograde cholangiopancreatography (ERCP)]].
-* The following result of [gold standard test] is confirmatory of [disease name]:
-** Result 1
-** Result 2
-* The [name of investigation] should be performed when:
-** The patient presented with symptoms/signs 1. 2, 3.
-** A positive [test] is detected in the patient.
-* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
-* The diagnostic study of choice for [disease name] is [name of investigation].
-* There is no single diagnostic study of choice for the diagnosis of [disease name].
-* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
-* [Disease name] is mainly diagnosed based on clinical presentation.
-* Investigations:
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
-** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
-==== The comparison table for diagnostic studies of choice for [disease name] ====
-{|
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
-|}
-<small> ✔= The best test based on the feature </small>
-===== Diagnostic results =====
-The following result of [investigation name] is confirmatory of [disease name]:
-* Result 1
-* Result 2
-===== Sequence of Diagnostic Studies =====
-The [name of investigation] should be performed when:
-* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
-* A positive [test] is detected in the patient, to confirm the diagnosis.
 === Diagnostic Criteria ===
-* Here you should describe the details of the diagnostic criteria.
+*The diagnosis is difficult to establish as the laboratory results and the imaging may be normal.
-*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
-*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
-*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
-*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
-*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
-*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
-*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
-* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
-* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
-* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
-* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
-** Criteria 1
-** Criteria 2
-** Criteria 3
-IF there are clear, established diagnostic criteria:
+===== Diagnostic findings suggestive of chronic pancreatitis: =====
-*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
+Diagnostic findings suggestive of chronic pancreatitis include the triad of:
-*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
+* [[Pancreatic]] [[Calcification|calcifications]]
-*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
+* [[Steatorrhea]]
-IF there are no established diagnostic criteria:
+* [[Diabetes mellitus]]
-*There are no established criteria for the diagnosis of [disease name].
+===== Diagnostic findings confirmatory for Chronic pancreatitis: =====
+Diagnostic findings confirmatory for chronic pancreatitis may include
+* [[Pancreatic]] [[Calcification|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)
 ==References==