Lundy test

The Lunde test is carried out by the following principle. The food can enter the stomach to directly or indirectly stimulate the secretion of the pancreas. The fatty acids and amino acids in the food can stimulate the cholecystokinin (CCK) in the upper part of the duodenum and jejunum, and CCK promotes the secretion of digestive enzymes in the pancreas. Basic Information Specialist classification: Digestive examination classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value Normal human trypsin secretion is 60 IU/kg.h (peak concentration). Clinical significance The positive rate of chronic pancreatitis test is 80%-90%, and the positive rate of pancreatic cancer test is 70%-80%. Abnormal results: Chronic pancreatitis mainly manifests as abdominal pain, weight loss, malnutrition, diarrhea or fatty sputum. Later, abdominal mass, jaundice and diabetes may occur. 2. Abnormal symptoms of pancreatic cancer: 1, abdominal pain: for the early symptoms of pancreatic cancer, more common in the pancreatic body and pancreatic cancer, located in the upper abdomen, umbilical or right upper abdomen, the nature of colic, paroxysmal or persistent, progressive aggravation of dull pain, mostly Radiation to the lower back, aggravation in the lying position and in the evening, the pain can be alleviated when sitting, standing, leaning forward or walking. 2, jaundice: in a certain stage of the disease may have jaundice, generally pancreatic head cancer jaundice is more common, and appears earlier, cancer is limited to the body, the tail is more without jaundice. Astragalus is mostly obstructive, with progressive deepening, accompanied by itchy skin, urine color such as strong tea, and feces into terracotta. Most of them are caused by the compression of the common bile duct in the head of the pancreatic head, and a small number is caused by the metastasis of the pancreatic body and tail cancer to the liver or the lymph nodes of the liver/choledochal. 3, about 90% of patients have rapid and significant development of weight loss, often accompanied by bad quality in the late stage of pancreatic cancer. Causes of weight loss include cancer consumption, loss of appetite, anxiety, insomnia, digestion and malabsorption. 4, fatigue and loss of appetite are very common, can be accompanied by gastrointestinal symptoms such as diarrhea constipation, abdominal distension, nausea. In some cases, steatorrhea and hyperglycemia and diabetes can occur. If you don't like fatty dishes, you will also have fatty diarrhea, which is a squat that is not digested by fat, mixed with feces, and excreted. 5, due to cancer ulceration or infection, but also due to secondary bile duct infection and fever. 6, part of the pancreatic body, tail cancer can be seen in the limb vein thrombosis phlebitis, resulting in local limb edema. 7, physical examination in the early days generally no obvious signs. Typical cases can be seen in weight loss, jaundice, and tenderness in the upper abdomen. In the advanced stage, a nodular, hard mass can be reached in the upper abdomen. Such as jaundice with gallbladder enlargement, it is an important basis for pancreatic head cancer. Due to cholestasis, it can often be swollen and the liver is swollen. If the cancer is compressed by splenic vein or splenic vein thrombosis, it can cause swelling and splenomegaly. 8, advanced pancreatic cancer cases can occur ascites, and can be on the left collarbone or rectum recession and hard and enlarged metastatic lymph nodes. People who need to be examined: patients with chronic pancreatitis, pancreatic cancer and other related symptoms. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. 1. After gastric resection, vagus nerve resection, small intestine malabsorption, ampullary obstruction, etc., this test is not suitable, because the above factors affect the accuracy of the test results. 2. Other gastrointestinal mucosal structures and dysfunctional diseases, such as duodenal ulcer, Zhuo-Eye syndrome, destruction of intestinal lipase, etc. can affect the test results. Inspection process method: 1. Anti-cholinergic drugs, H-blockers and other drugs that affect the secretion of digestive glands are banned within 24 hours before the test. 2. Fasting water after dinner on the day before the test, fasting >12h. 3. Lundh meal preparation: vegetable oil 18g, skim milk powder (or casein) 15g, glucose 40g, flavored syrup 15g, add water to 300ml. It contains 6% fat, 5% protein, and 15% sugar. 4. On the morning of the test, fasting, intramuscular injection of metoclopramide 10mg, inserted into the duodenal drainage tube, after positioning under the X-ray did reach the duodenum, then drink Lundh meal 300ml within 3min-5min . 5. The subject was quiet and lying down, collecting duodenal juice every 30 minutes for 4 times, lasting 2 hours. 6. Determine trypsin activity in each specimen separately. Not suitable for the crowd Inappropriate people: acute pancreatitis, suspected to be an acute cause of chronic pancreatitis. Adverse reactions and risks No obvious complications and harms.