The Long-Term Follow Up Study of Acute Pancreatitis By Means of Pancreatic Scintigraphy, Secretin Test and Oral Glucose Tolerance Test
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Morphologic and functional alternations of the pancreas following attack of acute pancreatitis were studied in 29 cases by pancreatic scintigraphy, standard Secretin test and oral glucose tolerance test (GTT).At the time of acute attack the diagnosis as acute pancreatitis had been confirmed at laparotomy in 27 cases and in 2 cases on clinical pictures and the serum amylase level. The mean duration of follow up was 56.3 months.The result of this studies are following:1) Normal images were obtained in 17 of 29 cases. 4 of these had slight to moderate decreased exocrine function judged by secretin test. In the remàining cases exocrine function was within normal limits. 12 of 16 cases with normal image had abnormal oral glucose tolerance curve of mild to moderate diabetes. The remaining cases had normal curve.2) There were 12 cases with abnormal scintigram. 10 of these cases had abnormal images with decrease of isotope uptake in part or the whole of the pancreas and 2 cases with absolute failure of isotope uptake by the pancreas. In general these changes were shown to be more apparent in the tail than the head of the pancreas.Ten of 12 cases with abnormal image had to some degree decreased function but in the remaining 2 cases pancreatic exocrine function was within normal limits. On GTT all of 12 cases with abnormal image had abnormal curve of diabetes. Especially 4 of these cases had severe diabetes with not only marked decreased exocrine function but quite poorlyvisualized image of the pancreas.3) In 4 cases histopathological findings were obtained at the time of the study by laparotomy, and they were shown very consistent with scintigraphic features.4) On the scintigraphic procedure as well as function test of the pancreas, it was shown that alcoholic factor played a very important role in influencing the prognosis of acute pancreatitis.5) So far as 29 cases are concerned, it can be said that acute pancreatitis resulted in chronic pancreatitis in the 4 cases, or 14%. In the remaining 8 cases with abnormal scintigram, it is postulated that the inflamatory process subsided and allowed time for cicatrical fibrosis to occur. But it should be necessary to trace and study these alternations of the pancreas in future.