The diagnosis of pancreatic disease is gradually improving, largely as a result of increasing experience in correlating laboratory data reflecting normal and altered physiologic function and newer techniques for assessing the digestive capacity of pancreatic enzymes. Characteristic alterations of the quantity and constituents of the duodenal content have been established. These refinements have emphasized the importance of adequate understanding of the type, mechanism, and application of pancreatic function tests. In the present discussion these procedures are classified with respect to the moiety analyzed or the specific function evaluated (Table 1).
Determinations of Blood or Serum Constituents
A. Serum Amylase.
—Since Elman and his associates,9 in 1929, confirmed the presence of an increased serum amylase activity in inflammation or obstruction of the pancreatic duct, this analysis has become the most widely applied test of pancreatic disease. Although several biochemical systems have been employed, the saccharogenic method of Somogyi10,11 is