The American Journal of Digestive Diseases

, Volume 10, Issue 6, pp 530–544 | Cite as

Quantitative determination of fecal chymotrypsin as a screening test for pancreatic exocrine insufficiency

  • W. Dyck
  • R. Ammann
  • R. Ben Avraham
Article

Summary

The diagnostic value of quantitatively measuring fecal chymotrypsin and trypsin activity by using specific substrates has been studied. Objective evaluation of pancreatic exocrine function was accomplished with the pancreozymin-secretin test.

A close correlation was indicated between stool chymotrypsin concentration and the functional capacity of the exocrine pancreas. All patients in this study with severe and moderate functional impairment, as determined with the pancreozymin-secretin test, exhibited stool chymotrypsin values below 74 µg./gm. An additional group with mild pancreatic exocrine insufficiency had values between 74 and 100 µg./gm.

Fecal chymotrypsin assay by the technic described promises to be most helpful in screening for pancreatic disease. Pancreatic exocrine insufficiency can be virtually excluded as a diagnostic possibility when several stool specimens from the same patient show a chymotrypsin concentration greater than 100 µg./gm. Patients in the clearly abnormal range, with fecal chymotrypsin values below 74 µg./gm., and those in the questionable range, with values of 74–100 µg./gm. in 2 or more determinations, should be further investigated by duodenal intubation and the collection of pancreatic secretions following hormonal stimulation.

In contrast to the encouraging results obtained with chymotrypsin determinations, trypsin values in our study showed no significant correlations with pancreatic functional capacity.

Keywords

Trypsin Functional Capacity Chymotrypsin Pancreatic Disease Pancreatic Secretion 

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Copyright information

© Hoeber Medical Division • Harper & Row, Publishers 1965

Authors and Affiliations

  • W. Dyck
    • 1
  • R. Ammann
    • 1
  • R. Ben Avraham
    • 1
  1. 1.From the Medical “Poliklinik” and the Clinical-Chemical LaboratoriesUniversity of ZurichZurichSwitzerland

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