THE DIAGNOSIS of diseases of the pancreas has at all times presented a challenging problem to the clinician. The ability to detect signs of functional abnormality of this organ is limited by the fact that the pancreas has a large functional reserve and has the capacity for rapid return to normal activity.* Despite extensive destruction of the gland, few clinical signs may be present. Then, too, the anatomical location of the gland renders it inaccessible to the usual methods of physical diagnosis. Although great advances have been made in the roentgenographic approach to the pancreas, no reliable radiographic methods have, as yet, been developed to visualize it other than by its relations to neighboring viscera. The clinician, therefore, in diagnosing pancreatic disease, is dependent for all practical purposes upon three types of laboratory procedures:
study of the duodenal contents
study of the blood enzyme levels
DREILING DA, RICHMAN A. EVALUATION OF PROVOCATIVE BLOOD ENZYME TESTS EMPLOYED IN DIAGNOSIS OF PANCREATIC DISEASE. AMA Arch Intern Med. 1954;94(2):197–212. doi:10.1001/archinte.1954.00250020031002
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