Regulation of the pancreas


The pancreas, localized in the retroperitoneum, plays an important role in the digestion and uptake of food. The endocrine pancreas is formed by the islets of Langerhans, which secrete insulin and glucagon. The exocrine pancreas includes the acinar cells which secrete pancreatic juice. This juice contains a variety of enzymes:

Upon arrival of containing food containing lipids, proteins, and glucose in the duodenum (1), the cells in the wall of the duodenum release cholecystokinin (CCK) and gastric inhibitory peptide (GIP) into the circulation (2). CCK stimulates the release of pancreatic enzymes into the intestine (3). GIP stimulates the secretion of insulin by the pancreatic islets into the circulation (4).


The most sensitive and specific test to diagnose chronic pancreatitis is:


Female, 40 years, has daily abdominal pain. ERCP: normal bile ducts; pancreatogram: definite "mild" chronic pancreatitis. No alcohol and no FH of pancreatitis. Which of the following is true regarding this patient?