The exocrine pancreas synthesizes and secretes more than ten enzymes and proenzymes and a number of illnesses is associated with exocrine pancreatic insufficiency.
This book, in its second edition, presents up-to-date diagnostics and differential therapies of exocrine pancreatic insufficiency in a compact manner. It was restructured and information in each chapter was adapted and adjusted to comply with the latest scientific advances.
The result is a well-balanced and practice-oriented reference book which reflects the current state of knowledge on this subject and provides practical assistance not only to the interested clinical pancreatologist but to a wide group of readers.
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978-3-8374-5181-8 (9783837451818)
Schweitzer Klassifikation
1. Functional diagnostics 12
1.1. General information on exocrine pancreatic function 12
1.2. Direct pancreatic function tests 15
1.2.1. Secretin-pancreozymin test 15
1.2.2. Endoscopic secretin test 16
1.2.3. Lundh test 17
1.3. Indirect pancreatic functional tests 18
1.3.1. Fecal elastase-1 18
1.3.2. Quantitative stool fat analysis 19
1.3.3. Fecal chymotrypsin 20
1.3.4. Pancreolauryl test 21
1.3.5. Amino acid consumption test 22
1.3.6. Breath tests 23
1.4. Pancreatic enzymes in the serum 24
1.5. Secretin MRCP 24
1.6. Summary 25
2. Pancreatic enzymes 28
2.1. History of pancreatic enzymes and enzyme substitution 28
2.2. The various pancreas enzyme preparations 30
2.3. Galenics 31
2.4. Intolerance and allergies 35
3. Therapy of exocrine pancreatic insufficiency 38
3.1. Aims and indications 38
3.2. General measures 38
3.3. Diet 39
3.4. Supplementing with trace elements and vitamins 40
3.5. Enzyme substitution 41
3.6. Enzyme substitution as pain therapy 46
4. Exocrine pancreatic insufficiency in association with pancreatic illnesses 50
4.1. Acute pancreatitis 50
4.2. Hereditary pancreatitis 50
4.3. Autoimmune pancreatitis 50
4.4. Cystic fibrosis (Mucoviscidosis) 51
4.5. Pancreatic carcinoma 53
4.6. Diabetes mellitus 54
5. Exocrine pancreatic insufficiency as a concomitant illness 58
5.1. Autoimmunopathy and connectivitis 58
5.2. Chronic inflammatory bowel diseases 58
5.3. Pancreatic insufficiency in association with IBS 59
5.4. Pancreatic insufficiency in association with the hepato-biliary system 59
5.5. Viral infections 59
5.6. Postoperative conditions 59
5.6.1. Pancreas resection 59
5.6.2. Gastric resection 60
5.6.3. Intestinal resection 61
5.7. Sporadic illnesses associated with exocrine pancreatic insufficiency 61
5.8. Exocrine pancreatic insufficiency in women 62
5.9. Pancreatic anomalies 62
5.10. Trauma to the pancreas 62
5.11. The exocrine Pancreas in geriatric patients 62
6. Syndromes 66
6.1. CEL 66
6.2. Shwachman syndrome and Johanson Blizzard syndrome 66
6.3. Isolated lipase deficiency 67
7. Summary and outlook 70
8. Internet Links 72
9. Literature 74
Index 90
