[The diagnostic procedure in pancreatic diseases]

Once a diagnosis of acute pancreatitis is established it is necessary to discriminate between an edematous-interstitial and a necrotizing course of the disease, to determine the extent and location of necroses by contrast-enhanced CT and to detect early infection by ultrasound guided needle aspiration. In chronic pancreatitis it is imperative to ascertain the severity by ERCP, and to use imaging techniques to determine degree of functional impairment and the extent to which the inflammatory process has extended to the peripancreatic tissues by means of imaging techniques. Based on clinical data pancreatic carcinoma can not usually be detected until it is already in a late stage, but it can then be confirmed with great reliability by ERCP, contrast-enhanced CT, tumor marker tests and fine needle aspiration.