Diagnosis of Pancreatitis
Physicians often suspect pancreatitis in patients who experience persistent or recurrent abdominal pain and have a history of alcohol abuse. Diagnosis usually involves taking a medical history (including a family history and a history of symptoms) and performing a physical examination and diagnostic tests.
Other conditions, such as peptic ulcer, gallbladder inflammation (called acute cholecystitis), and intestinal obstruction often must be ruled out to make a definitive diagnosis.
During physical examination, the physician looks for signs of pancreatitis, including abdominal pain and bloating, low blood pressure, fever, and rapid heart rate.
Pancreatic function tests (e.g., blood tests, urine tests, stool tests) can detect abnormal levels of pancreatic enzymes (e.g., amylase, lipase), glucose (blood sugar), white blood cells (WBCs), and other substances (e.g., sodium, calcium, potassium), which can indicate pancreatitis.
Imaging tests (e.g., x-rays, ultrasound, CT scan) of the abdomen can be used to detect infection or inflammation of the pancreas, congenital abnormalities, gallstones, and pseudocysts (accumulations of fluid and damaged tissue).
Ultrasound uses high frequency sound waves to create images of the pancreas and surrounding structures. In a procedure called endoscopic ultrasound, sound waves are transmitted through a long, flexible tube (called an endoscope) that is inserted into the digestive tract through the mouth. Endoscopic ultrasound may provide more accurate images.
Computed tomography (CT scan), also called computerized axial tomography (CAT scan), involves taking x-rays from many different angles to create cross-sectional images of structures in the abdomen. In some cases, a contrast agent is administered orally about 60–90 minutes before the test. This contrast agent flows through the GI tract and enters the pancreas, providing clearer images of the pancreas and other digestive organs.