Significance of a Sonographic Secretin Test in the Diagnosis of Pancreatic Disease: Results of a Prospective Study

Abstract

In a prospective study the pancreatic duct diameter was measured sonographically before and after secretin stimulation in 20 healthy controls and 59 patients with upper abdominal pain, weight loss, and/or diarrhea. Whereas healthy controls and patients without pancreatic disease after secretin stimulation showed a distinct pancreatic duct dilatation of more than 90% of basal duct diameter, no distinct secretin-induced duct enlargement was observed in most patients with chronic pancreatitis. Patients with circumscript pancreatic duct stenosis even had a marked and longer-lasting duct dilatation after stimulation. In patients with anomalies of the pancreatic duct system, no uniform response was found after secretin injection. In this study the sonographic secretin test showed a sensitivity of 92% and a specificity of 95% for diagnosis of chronic pancreatitis. The results confirm that this diagnostic method can be recommended as a reliable screening test for pancreatic disease.

Pancreas and Aging: A Study Using Ultrasonography

“…Ultrasonic measurements of normal pancreatic duct diameter have been performed by different authors [4][5][6][7][8]. The duct diameters generally ranged from 1 to a maximum of 3 mm.…”

Comparison of Secretin-Stimulated Magnetic Resonance Pancreatography and Manometry Results in Patients with Suspected Sphincter of Oddi Dysfunction

“…Secretin is a hormone that stimulates pancreatic exocrine secretion and relaxation of the sphincter of Oddi (11,12). Although secretin induces dilation of the main pancreatic duct within 5 minutes after administration, with return to baseline by 10 minutes (13)(14)(15)(16), prolonged dilatation has been demonstrated in patients with papillary stenosis (17,18). If the sphincter is dysfunctional and obstructs flow, the main pancreatic duct may also dilate for a longer duration.…”

Ultrasonographic Observation of Secretin‐induced Pancreatic Duct Dilation in Healthy Cats

“…In most normal healthy human subjects, secretin induces a maximal dilation of 70–140% over basal pancreatic duct diameter within 1–5 min postsecretin administration 13–18,22 . The pancreatic duct then gradually decreases to approximately 25% over basal value at 15 min postsecretin administration 17 .…”

“…The majority (88%) of patients with chronic pancreatitis have an impaired response characterized by a 0% pancreatic duct dilation after administration of secretin 18 . This is due to periductal fibrosis, a consequence of long‐standing pancreatic inflammation, which decreases the compliance of the duct, thereby impairing its dilation 15,17,22 . Also, the loss of sufficient pancreatic secretory tissue may lead to an inability of the exocrine pancreas to produce a sufficient quantity of bicarbonate to cause pancreatic duct dilation, 22 although this is disputed 17 .…”