Exams and Tests

When a healthcare provider identifies symptoms suggestive of pancreatitis, specific questions are asked about the person's symptoms, lifestyle and habits, and medical and surgical history. The answers to these questions and the results of the physical examination allow the healthcare provider to rule out some conditions and to zero-in on the correct diagnosis.

In most cases, laboratory tests are needed. The tests check for several possibilities, including the following:

• Pancreas, liver, and kidney functions (including levels of pancreatic enzymes amylase and lipase)
  
  
• Signs of infections
  
  
• Blood cell counts indicating signs of anemia
  
  
• Pregnancy test
  
  
• Blood sugar, electrolyte levels (an imbalance suggests dehydration) and calcium level

Results of the blood tests may be inconclusive if the pancreas is still making digestive enzymes and insulin.

Diagnostic imaging tests are usually needed to look for complications of pancreatitis, including gallstones.

Diagnostic imaging tests may include the following:

• X-ray films may be ordered to look for complications of pancreatitis as well as for other causes of discomfort.
  
  
• A CT scan is like an x-ray film, only much more detailed. A CT scan shows the pancreas and possible complications of pancreatitis in better detail than an x-ray film. A CT scan highlights inflammation or destruction of the pancreas.
  
  
• Ultrasound is a very good imaging test to examine the gallbladder and the ducts connecting the gallbladder, liver, and pancreas with the small intestine.
   
  • Ultrasound is very good at depicting abnormalities in the biliary system, including gallstones and signs of inflammation or infection.
    
    
  • Ultrasound uses painless sound waves to create images of organs. Ultrasound is performed by gliding a small handheld device over the abdomen. The ultrasound emits sound waves that "bounce" off the organs and are processed by a computer to create an image. This technique is the same one that is used to look at a fetus in a pregnant woman.
     
• Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging test that uses an endoscope (a thin, flexible tube with a tiny camera on the end) to view the pancreas and surrounding structures.
   
  • ERCP is usually used only in cases of chronic pancreatitis or in the presence of gallstones.

• To perform an ERCP, a person is first sedated. After sedation, an endoscope is passed through the mouth, to the stomach, and into the small intestine. The device then injects a temporary dye into the ducts connecting the liver, gallbladder, and pancreas with the small intestine (biliary ducts). The dye makes is easier for the healthcare provider to see any stones or signs of organ damage. In some cases, a stone can be removed during this test.

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