Abstract
Intraduodenal tests of pancreatic function are invasive, expensive and time consuming. The measurement of pancreatic chymotrypsin in faeces is a commonly used alternative but it has not been adequately validated. We have assessed the test by simultaneous measurements of duodenal and faecal chymotrypsin in 30 children, aged 3 weeks to 13 years, with exocrine pancreatic function ranging from nil (5) through partial insufficiency (1) to normal function (24). Duodenal fluid was collected for 5 consecutive 10 minute periods following i.v. pancreozymin (2 units /kg). Apparent secretion rates (ug/kg/50 mins.) and mean concentrations of chymotrypsin were determined. Mean faecal chymotrypsin concentration was determined from 3 randan stools passed on separate days within 72 hours of the intraduodenal test. In the 25 children with measurable pancreatic function, the mean faecal chymotrypsin concentrations were significantly positively correlated with both duodenal chymotrypsin apparent secretion rate and mean concentration (Spearman's rank correlation coefficient 0.63 and 0.45, p = <0.001 and <0.01 respectively). The 5 children with undetectable levels of duodenal chymotrypsin had very low faecal chymotrypsin concentrations of only 3-10% of the lower limit of the reference range (120 ug/100 g stool). The child with reduced but measurable duodenal chymotrypsin had a faecal chymotrypsin of 33% of the lower limit. All 24 children with normal function had mean faecal chymotrypsin concentrations within the reference range. Faecal chymotrypsin is a rapid, simple, cheap, readily repeatable, non-invasive test which should always be done before contemplating intraduodenal assessment of pancreatic function.
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Brown, G., Sule, D., Puntis, J. et al. 96. FAECAL CHYMOTRYPSIN, A BETTER TEST OF EXOCRINE PANCREATIC FUNCTION. Pediatr Res 22, 112 (1987). https://doi.org/10.1203/00006450-198707000-00117
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DOI: https://doi.org/10.1203/00006450-198707000-00117