Pancreas, Spleen, and Reticuloendothelial System

Abstract

The pancreas is a mixed exocrine—endocrine organ that is almost impossible to evaluate during a physical examination owing to its retroperitoneal location. Previous evaluation of the pancreas had relied on the availability of laboratory screening tests such as amylase and lipase levels, which when abnormal are relatively nonspecific. Until approximately 10 years ago, the pancreas had been difficult to evaluate radiographically as well, with the diagnosis relying on direct pressure effects exerted on adjacent organs such as the stomach and small bowel produced by pancreatic masses. Occasionally, calcifications of chronic pancreatitis were detected on plain films. Unfortunately, malignant disease at the time of detection utilizing these modalities was usually far advanced and most often incurable. The other diagnostic modalities available were angiography and endoscopic retrograde cholangiopancreatography (ERCP), both of which are more invasive and could not be used as screening procedures.