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Tests

  • Lipase (the pancreatic enzyme that, along with bile from the liver, digests fats) increases in the blood within 4 to 8 hours of the beginning of an acute attack and peaks at 24 hours. It may rise to several times its normal level and remains elevated longer than amylase. As cells are destroyed with chronic pancreatitis and as lipase production drops to less than 10% of the normal level, steatorrhoea (fatty, foul-smelling stools) will form.
  • Amylase (the pancreatic enzyme responsible for digesting carbohydrates) used to be the most common blood test for acute pancreatitis but now is being replaced by lipase. It increases from 2 to 12 hours after the beginning of symptoms and peaks at 12 to 72 hours. It may rise to 5 to 10 times the normal level and will usually return to normal within a week. It is less specific for pancreatitis than lipase as amylase is also produced in other tissues (e.g. salivary glands). Amylase also may be monitored with chronic pancreatitis, it will often be moderately elevated until the cells that produce it are destroyed.
  • Stool chymotrypsin tests and more commonly stool elastase enzyme tests are used to check for pancreatic insufficiency and may be part of a work-up for chronic pancreatitis. Immunoreactive trypsin (IRT) is a blood test that may be used to check pancreatic sufficiency in those with chronic pancreatitis. Faecal fat may also be used to check for pancreatic sufficiency.

Other tests that may be used to check for complications of acute pancreatitis include:

Non-laboratory tests may include:

  • Abdominal ultrasound
  • CT (computed tomography) scan to look for complications of pancreatitis such as necrosis or pseudocyst formation
  • ERCP (endoscopic retrograde cholangiopancreatography), a flexible scope used to inject contrast dye into the bile, pancreatic and hepatic ducts from their opening in the duodenum to see and sometimes assist to remove gallstones
  • MRI (magnetic resonance imaging)
  • Secretin testing (not widely available) in which a tube is positioned in the duodenum to collect pancreatic secretions stimulated by IV secretin to test for pancreatic sufficiency in chronic pancreatitis

Last Review Date: September 5, 2017