The investigation and management of pancreatic exocrine insufficiency: A retrospective cohort study

Shandro, Benjamin; Ritehnia, Jennifer; Chen, Joshua; Nagarajah, Rani; Poullis, Andrew

doi:10.7861/clinmed.2020-0506

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…The diagnosis of pancreatic exocrine insufficiency was based on a clinical history of steatorrhea and the need for pancreatic enzyme supplementation or pathological test results in exocrine function tests (no enzyme replacement required: one point; enzyme replacement required: two points). Severe exocrine insufficiency was defined by fecal elastase‐1 ≤ 100 μg/g based on recent guidelines 18,19 . Endocrine insufficiency was defined as per HbA1c measurement (4 points).…”

Section: Methodsmentioning

confidence: 99%

“…Severe exocrine insufficiency was defined by fecal elastase‐1 ≤ 100 μg/g based on recent guidelines. 18 , 19 Endocrine insufficiency was defined as per HbA1c measurement (4 points). The morphological status of the pancreas was divided into normal, equivocal (1 point), mild (2 points), moderate (3 points) and marked (4 points).…”

Section: Methodsmentioning

confidence: 99%

“…The median disease duration was 20 months. The median Child-Pugh score in LC patients was 7 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Further demographics are shown in Table 1.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

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Point‐shear wave elastography generated by acoustic radiation force impulse in chronic pancreatitis

Wekerle,

Murillo,

vonBoscamp

et al. 2024

UEG Journal

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BackgroundTranscutaneous point‐shear wave elastography (p‐SWE) performed using an acoustic radiation force impulse can be used to quantify pancreatic stiffness in chronic pancreatitis (CP). We aimed to evaluate its usefulness to diagnose and monitor CP.Methods175 participants were included in this prospective study including patients with CP (n = 65), liver cirrhosis (LC; n = 60), alcohol abuse (n = 10) and healthy controls (n = 40). Point‐shear wave elastography of the pancreas was performed and quantified as median shear wave velocity (SWV). In the same way, p‐SWE of the spleen served as a marker of portal hypertension. The M‐ANNHEIM Severity score was used as global marker for disease activity in CP.ResultsCompared to healthy controls, pancreatic SWV was significantly elevated in CP (1.38 vs. 0.96 m/s; p < 0.0001, MWU‐test). Pancreatic SWV was increased in alcoholic CP but not in hereditary CP. Receiver operating characteristic analysis revealed 1.2 m/s as the optimal cut‐off to identify non‐heredity‐CP subjects (90% specificity; 81% sensitivity; 92% positive predictive value). Pancreatic SWV correlated significantly with the M‐ANNHEIM Severity score, severity of CP‐typical complications (both p < 0.05, linear regression analysis), morphological changes of the pancreas and need for hospital treatment (both p < 0.05, MWU‐test) but not with exocrine or endocrine insufficiency. Pancreatic SWV >1.7 m/s was identified to predict M‐ANNHEIM Severity score ≥11 points. Pancreatic SWV was also elevated in LC (1.42 m/s; p < 0.001), correlating with increased splenic SWV.ConclusionTranscutaneous pancreatic p‐SWE represents a bedside, cost‐effective and non‐invasive tool which adds valuable information to the process of diagnosing and monitoring CP. By portal hypertension, an increased pancreatic SWV must be expected.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Point‐shear wave elastography generated by acoustic radiation force impulse in chronic pancreatitis

Wekerle,

Murillo,

vonBoscamp

et al. 2024

UEG Journal

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A Systematic Review of Exocrine Pancreatic Insufficiency Prevalence and Treatment in Type 1 and Type 2 Diabetes

Lewis

2023

Diabetes Technology & Therapeutics

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Pancreatic Exocrine Insufficiency in Type 2 Diabetes

Naina,

Prasad,

Jothydev

et al. 2023

International Journal of Diabetes and Technology

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Pancreatic exocrine insufficiency (PEI) is defined as malabsorption caused by impaired nutrient digestion, particularly of fats. Studies have demonstrated that one of the factors that contribute to the increased risk of PEI is diabetes. It is unfortunate that very often PEI is underdiagnosed and undertreated or misdiagnosed which leads to severe adversities. This report describes the case of a 50-year-old male with PEI misdiagnosed initially and later treated effectively with appropriate diagnosis and prompt interventions.

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The investigation and management of pancreatic exocrine insufficiency: A retrospective cohort study

Cited by 4 publications

References 16 publications

Point‐shear wave elastography generated by acoustic radiation force impulse in chronic pancreatitis

Point‐shear wave elastography generated by acoustic radiation force impulse in chronic pancreatitis

A Systematic Review of Exocrine Pancreatic Insufficiency Prevalence and Treatment in Type 1 and Type 2 Diabetes

Pancreatic Exocrine Insufficiency in Type 2 Diabetes

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