Malabsorption pancreatogenous

Summary of Differential Diagnosis of Pancreatogenous and Enterogenous Malabsorption. 76... 

Bile salt deficiency must also be directly studied. It may occur in the absence of obstruction or obvious liver disease (R7). The majority of patients with one form or another of the sprue syndrome will be found to have pancreatic enzymes and bile salts within the normal range. Pancreatic enzymes are absent or markedly deficient in patients with pancreatogenous malabsorption syndrome (B17, F13). It is surprising how frequently this necessary step in differential diagnosis is omitted. 

Radiographic study of the small intestine may provide useful information (A6, F12, F14, K4, L2, M2, P3). If a simple suspension of barium sulfate is used, the upper small intestine of a normal person usually displays a fine feathery appearance a similar pattern is seen in most patients with pancreatogenous malabsorption. In the patient with enteropathy, however, the opaque medium appears in massive clumps. This was at one time thought to be due to vitamin deficiencies, but it was demonstrated experimentally that the cause was flocculation of the barium sulfate with excessive secretion of mucus. This clumped appearance may be seen in normal children, possibly due to the... 

The main points in differential diagnosis between the sprue group and pancreatogenous malabsorption are summarized in Table 1. Occa-... 

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