Chronic pancreatitis has been drawing much attention recently, and its diagnosis has been made clinically not infrequently. For diagnosing chronic pancreatitis, the usual means are amylase determination in urine and serum, glucose tolerance test, Vagostigmin test and Secretin test, pancreatic tender point test and the evaluation of subjective symptoms. In chronic pancreatitis, amylase activity in urine and serum was within normal limits and had no diagnostic significance. As to subjective symptoms, indefinite abdominal signs were noticed in the majority of the cases with chronic pancreatitis; however, since they were commonly found also among other disorders of the digestive organs, they did not seem to be characteristic for chronic pancreatitis. KUDO proposed the method of testing pancreatic tender point which was reported to be valuable as a supplementary diagnostic procedure. Further more, the author evaluated both Vagostigmin and secretin tests with the methods of Van-Loon-Yanaga.
In chronic pancreatitis, Vagostigmin test was reported to be positive in 72-92% of the cases with chronic pancreatitis. The author compared it with the pancreatic tender point test. Vagostigmin test modified by Ottenstein-Baltzer-Yamagata, and anterior abdominal tender point of KUDO method, agreed in 86%. In comparison with Vagostigmin test modified by Van-Loon-Yanaga, they agree in 85%.
Glucose tolerance test agreed i1181%of the cases studied with the anterior abdominal pancreatic tender point test of KUDO method. In addition, glucose tolerance test agreed in 88%of the cases studied with Vagostigmintest.
The author compared the result of secretin test with the anterior abdominal pancreatic tender point test of KUDO method among 20 cases showing the positive tender point test. As far as the volume of the pancreatic juice obtained is concerned, they agreed in 65%, the maximum bicarbonate concentration in 65%, and amylase activity of the pancreatic juice in 55%. The secretin test was positive when two out of the above mentioned three compohents were abnormal. Thus, the result of the secretin test agreed with that of the pancreatic tender point test in 65%.
As mentioned above, the pancreatic tender point paralleled well to the results of vagostigmin, glucose tolerance test and secretin test. Therefore, the pancreatic tender point test proposed by KUDO is simple and practical for diagnosing chronic pancreatitis and helpful to practitioners poorly equipped for various laboratory tests in their daily examination of many patients. Further more, it is an important supplementary diagnostic method for screening purpose.
KUDO method
The method of palpating the abdomen on recumbent position with both legs bent up and the lower back elevated.
View full abstract