Acute Pancreatitis Testing and Diagnosis
Diagnosis of Acute Pancreatitis
Acute pancreatitis is confirmed by medical history, physical examination, and typically a blood test (amylase or lipase) for digestive enzymes of the pancreas. Blood amylase or lipase levels are typically elevated 3 times the normal level during acute pancreatitis. In some cases when the blood tests are not elevated and the diagnosis is still in question, abdominal imaging, such as a computed tomography (CT) scan, might be performed.
After diagnosis is confirmed, certain imaging tests might be performed during hospitalization or after to help identify the cause. Such tests include:
This is commonly performed during hospitalization to specifically evaluate the gallbladder for stones because gallstones are the most common cause of acute pancreatitis. Ultrasound uses sound waves that bounce off the pancreas, gallbladder, liver, and other organs, and their echoes generate electrical impulses that create an image—called a sonogram—on a video monitor. If gallstones are causing inflammation, the sound waves will also bounce off of them, showing their location.
Endoscopic ultrasound (EUS)
This test is not commonly required during acute pancreatitis. Compared to transabdominal ultrasound, it is relatively more invasive, in that a physician passes a flexible thin tube down into the stomach. A camera and ultrasound probe are attached to the end of the tube, which enable the physician to look at images of the gallbladder, pancreas, and liver. The images are more sensitive than those of transabdominal ultrasound in detecting small stones in the gallbladder and bile ducts that may have been missed. It can also visualize the pancreas for abnormalities. To read more about this, please click here.
Magnetic resonance cholangiopancreatography (MRCP)
MRCP uses magnetic resonance imaging (MRI), a noninvasive procedure that produces cross-section images of parts of the body. After being lightly sedated, the patient lies in a cylinder-like tube. The technician injects dye into the patient’s veins, which helps show the pancreas, gallbladder, and pancreatic and bile ducts. This is another sensitive test for evaluating the gallbladder, bile ducts, and pancreas for causes of acute pancreatitis.
Computerized tomography (CT)
A CT scan is a noninvasive radiograph (x-ray) that produces 3-dimensional images of parts of the body. The patient lies on a table that slides into a donut-shaped machine. Typically not performed initially for an episode of acute pancreatitis, it may be performed when a diagnosis is uncertain or several days into hospitalization to evaluate the extent of pancreatic damage when a patient is not recovering as quickly as expected.