To find out whether you have acute pancreatitis, the doctor will first feel your abdomen (belly) with their hands. They will also ask about various risk factors for pancreatitis, such as alcohol consumption, medication use and possible signs of gallstones such as a cramping pain in the upper abdomen (biliary colic). They usually take a sample of blood and will likely also do an ultrasound scan. If you are diagnosed with pancreatitis, you will be referred to a hospital. The symptoms of pancreatitis can also be caused by other medical conditions, such as an inflamed gallbladder, a heart attack or a gastric perforation from an ulcer.
Various things are measured in the blood sample, including the lipase levels in the blood. Lipase is an enzyme that is made in the pancreas and usually flows into the intestine. Abnormally high levels of lipase in the blood are a sign of pancreatitis. Having certain other substances in the blood can be a sign of a blocked bile duct.
An ultrasound scan of the belly is usually enough to tell whether gallstones are the cause. If the inflammation has led to changes in the pancreas, they can often be seen in an ultrasound scan too.
Sometimes more testing is needed. For instance, a magnetic resonance imaging (MRI) scan can be done to create a picture of the bile ducts and any gallstones. Another option is to use an endoscope to look for gallstones in the bile duct. This involves pushing a flexible tube with an ultrasound device at the end of it into the duodenum through the food pipe (endoscopic ultrasound).
A computed tomography (CT) scan can be used to detect complications such as dying tissue and to get an idea of how the inflammation is developing. If the pancreatitis is associated with gallstones or a bile duct infection, endoscopic retrograde cholangiography (ERC) may be needed for the diagnosis. This also involves passing an endoscope through the food pipe and down to the bile duct opening in the duodenum. A contrast medium (dye-like substance) is then injected into the duct to make any stones that are there show up in the x-ray image. With the help of the endoscope, these stones can also be removed during the examination. But ERC involves exposure to radiation, and may cause various complications.