Pancreatic atrophy

Question

Hello,
the conclusions of the last MRI performed in January 4, 2014 shows = "slight increase of the cystadenoma size with no change of the pseudo solid portion of the pancreatic head, increase in dilatation of the main pancreatic upstream duct and pancreatic atrophy". Elastase value (April 17, 2013) was 543 μg/g. In the light of these results and findings of MRI in 2014, I am wondering if I need a treatment for pancreatic insufficiency. I am very limited in my diet, fats tend to be poor digestibility and however I have no weight loss, no pain. Thank you for your review. Best regards

Answer

Dear questioner,

MRI provides us with anatomical information, but does not allow us to clarify whether the pancreatic function is impaired. The determination of fecal elastase is the most sensitive test to assess whether there is a pancreatic insufficiency. The value you specify seems to indicate that the pancreatic function is normal. Clinical symptoms (poor tolerance of fat) might be due to the presence of pancreatic insufficiency. Pancreatic function may change over time. Do not hesitate to re-measure fecal elastase. It could also be interesting to quantify the steatorrhea (=excreation of fat via the stool over one or three days) in order to quantify the undigested fat.

Best regards.
Pr. Michel Abely

19.05.2014