[The secretin test with the standard dose and high dose in chronic pancreatitis]

Sequential standard (1.0 U/kg) and augmented (4.0-5.0 U/kg) secretin response of the pancreas has been briefly compared in normal subjects and in pathologic series. The results of sequential testing led to the conclusion that, for clinical purposes, the standard test is sufficient for the diagnosis of well established pancreatic pathologies causing gross destruction of the parenchyma, while the augmented test is of particular value when the response to 1 U/kg produces equivocal results, since a higher stimulation enhances the masked secretory deficiency. The application of the augmented stimulus in alcoholic patients suggested the hypothesis that the post-secretin response pattern of minimal pancreatic inflammatory pathology is hypersecretion. Repeated observations in alcoholic hypersecretors will provide physiologic data elucidating the evolution of pancreatic pathology towards the end stages of chronic pancreatitis.