Chronic pancreatitis diagnostic study of choice: Difference between revisions
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* Abnormal pancreatogram showing ectatic side branches from the main pancreatic duct | * Abnormal pancreatogram showing ectatic side branches from the main pancreatic duct | ||
* Abnormal pancreatic function tests (Secretin test) | * Abnormal pancreatic function tests (Secretin test) | ||
== M-ANNHEIM diagnostic criteria of chronic pancreatitis == | |||
* The diagnosis usually requires a typical history of chronic pancreatitis (recurrent pancreatitis or abdominal pain). | |||
* The diagnosis for the various forms of chronic pancreatitis can be established by the following features. | |||
{| class="wikitable" | |||
!Form of chronic pancreatitis | |||
!Diagnostic criteria | |||
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|Definite chronic pancreatitis | |||
|Established by one or more of the following additional criteria | |||
* Pancreatic calcifications | |||
* Moderate or marked ductal lesions (according to the Cambridge classification) | |||
* Marked and persistent exocrine insufficiency defined as pancreatic steatorrhea markedly reduced by enzyme supplementation | |||
* Typical histology of an adequate histological specimen | |||
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|- | |||
|Probable chronic pancreatitis | |||
|Established by one or more of the following additional criteria | |||
* Mild ductal alterations (according to the Cambridge classification) | |||
* Recurrent or persistent pseudocysts | |||
* Pathological test of pancreatic exocrine function (such as fecal elastase-1 test, secretin test, secretin–pancreozymin test) | |||
* Endocrine insufficiency (i.e., abnormal glucose tolerance test) | |||
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===== M-ANNHEIM pancreatic imaging criteria for US, CT, MRI/MRCP, and EUS based on imaging features as defined by the Cambridge classification ===== | ===== M-ANNHEIM pancreatic imaging criteria for US, CT, MRI/MRCP, and EUS based on imaging features as defined by the Cambridge classification ===== |
Revision as of 23:06, 18 November 2017
Chronic pancreatitis Microchapters |
Diagnosis |
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Treatment |
Case Studies |
American Pancreatic Association Practice Guidelines |
Chronic pancreatitis diagnostic study of choice On the Web |
American Roentgen Ray Society Images of Chronic pancreatitis diagnostic study of choice |
Risk calculators and risk factors for Chronic pancreatitis diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
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."
- 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 {{CMG}}, your name template, and the microchapter navigation template you created at the beginning.
- Remember to create links within WikiDoc by placing [[square brackets]] 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/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 results
The following result of [investigation name] is confirmatory of [disease name]:
- Result 1
- Result 2
Sequence of Diagnostic Studies
- The diagnosis is difficult to estab
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)
M-ANNHEIM diagnostic criteria of chronic pancreatitis
- The diagnosis usually requires a typical history of chronic pancreatitis (recurrent pancreatitis or abdominal pain).
- The diagnosis for the various forms of chronic pancreatitis can be established by the following features.
Form of chronic pancreatitis | Diagnostic criteria | ||
---|---|---|---|
Definite chronic pancreatitis | Established by one or more of the following additional criteria
|
||
Probable chronic pancreatitis | Established by one or more of the following additional criteria
|
||
M-ANNHEIM pancreatic imaging criteria for US, CT, MRI/MRCP, and EUS based on imaging features as defined by the Cambridge classification
Cambridge grading | CT, US, MRI/MRCP | EUS |
---|---|---|
Normal | Quality study depicting whole gland without abnormal features | |
Equivocal | One abnormal feature | Four or fewer abnormal features (no differentiation between equivocal and mild) |
Mild changes | Two or more abnormal features, but normal main pancreatic duct | |
Moderate changes | Two or more abnormal features, including minor main Five or more abnormal features pancreatic duct abnormalities (either enlargement between 2 and 4 mm or increased echogenicity of the duct wall) | Five or more abnormal features (no differentiation between moderate and marked) |
Marked changes | As above with one or more of the required features of marked changes |