FECAL TRIGLYCERIDES AND FATTY-ACIDS IN THE DIFFERENTIAL-DIAGNOSIS OF PANCREATIC INSUFFICIENCY AND INTESTINAL MALABSORPTION IN PATIENTS WITHLOW-FAT INTAKES

To investigate possible parameters for the differential diagnosis of s teatorrhoea in patients with low fat intakes, faecal specimens were an alysed from 15 patients with steatorrhoea due to chronic pancreatitis and seven patients with steatorrhoea due to intestinal malabsorption. The fat intakes of the patients ranged from 30.1 to 60 g, less than th e average in American and European patients. The group with pancreatic steatorrhoea showed a significantly lower faecal output than the grou p with intestinal steatorrhoea but the two groups did not differ signi ficantly in their total faecal fat excretion or concentration. The per centage triglycerides and the molecular ratio of triglycerides to fatt y acids in the faeces were significantly higher (P < 0.01) in the grou p with pancreatic steatorrhoea than in those with intestinal steatorrh oea. The molecular percentage ratio of triglycerides to fatty acids wa s 6.8 +/- 2.2 for the chronic pancreatitis group and 2.4 +/- 1.0 for t he intestinal malabsorption group; while the respective faecal hydroxy fatty acid contents were 3.1 +/- 3.6% and 10.1 +/- 3.3% (means +/- SD s). These latter two parameters appeared to be the most valuable for d istinguishing the two forms of steatorrhoea.