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- Title
The Secretin Test as an Aid in the Differential Diagnosis of the Steatorrheas with a Report of Fourteen Cases∗†.
- Authors
Diamond, Joseph S.; Siegel, Sigmund A.; Myerson, Samuel
- Abstract
A series of fourteen cases of steatorrhea are here presented. The symptoms were identical in all instances except for differences in the degree of severity. Clinically they resembled sprue. This was especially manifest in the nine patients more severely affected. Complete studies were carried out including blood calcium and phosphorus, sugar curves, serum protein, basal metabolism and fat studies in the stool. In six cases complete quantitative studies were made of the neutral fats, split fats, fatty acids and soaps. X-ray studies were made including morphological pattern variations in the small intestines. Secretin studies were carried out in all instances. In six cases the test was repeated from two to four times. In ten cases the secretin test revealed pancreatic deficiencies characterized particularly by marked deficiencies in lipase. Several also showed diminished volume, bicarbonate concentration and trypsin output. In the remaining four cases the secretin test gave normal findings. The older clinical methods gave us no clue as to the differentiation of the type of steatorrhea. Nutritional disturbances as well as anemia, hypocalcemia and avitaminosis. etc., were present in both groups. Neither did quantitative fat studies in the feces for the estimation of neutral and split fats afford us any reliable data to distinguish one type from another. Split fats were found in a high percentage in all instances. In the secretin test we have a valuable method to determine the function of the pancreas. Secretin provides a standard pancreatic stimulus and with the aid of the double tube method opportunity is afforded for a complete quantitative study of the external secretory capacity of the pancreas. By repeated studies with the secretin test at various stages of the disease we have been able to observe the gradual improvement in the function of the gland. We have also learned that in the steatorrheas where the pancreatic function is disturbed these disturbances in...
- Subjects
SECRETIN; SPRUE; PANCREATIC diseases; GASTROINTESTINAL hormones; SMALL intestine
- Publication
American Journal of Gastroenterology (Springer Nature), 1982, Vol 77, Issue 10, p723
- ISSN
0002-9270
- Publication type
Article