Laboratory methods of research of chronic pancreatitis
Research of peripheral blood. In the period of an aggravation the leukocytosis and the accelerated SOE is noted. A leukocytosis more than 11 x 109/l and SOE more than 30 mm/h are inherent in chronic pancreatitis with a heavy current. At the patient with chronic pancreatitis anemia can be observed. Research of activity of enzymes. Amilazny test. Increase of activity and - amylases is important in recognition of exacerbations of chronic pancreatitis. Use determination of activity of other enzymes less often: lipases of serum, serum trypsin, elastase of blood serum and phospholipase of A2. Pancreatic elastase-1 is formed only in acinar cells therefore its change is a high-specific indicator of damage of a pancreas.
The survey X-ray analysis of abdominal organs — allows to reveal gland calcification with characteristic localization near the II lumbar vertebra. Ultrasonography of a pancreas — can find increase in acoustic density of gland, emergence of roughness of contours and change of the sizes, existence of cysts, pseudocysts, kaltsinat and deformations of channels of gland. Endoscopic ultrasonography allows to avoid the hindrances created by gas in intestines and fatty tissue. Also for specification of the diagnosis the computer tomography, a magnetic and resonant tomography, a fibrogastroduodenoskopiya is used. endoscopic retrograde pankreatokholangiografiya, laparoscopy.
Methods of an assessment of vneshnesekretorny function of a pancreas
Research calla. The steatorrhea (neutral fat in Calais) is observed at 30 — 35% of patients with moderately severe chronic pancreatitis and at 65-75% of patients with severe forms of chronic pancreatitis. Strong indications of insufficiency of products of a lipase demonstrate defeat of 70 — 90% of parenchymatous elements of a pancreas. The steatorrhea owing to insufficiency of a lipase is the most precursory symptom of vneshnesekretorny insufficiency of a pancreas, the creatorrhea (muscle fibers in Calais), starch, the digested cellulose can be observed later. Secretin-pankreoziminovy the test, Luid's test, RAVA-(PABK-) the test which description is provided in the special managements give to establishment of the correct diagnosis help.