Secretin (ChiRhoStim) Pancreas Perfusion for Pancreatic Adenocarcinoma

By distending the pancreatic duct with secretin injection, we believe ductal dilation and
cutoff will be accentuated. The investigators will be able to take advantage of this
physiologic effect of secretin, by obtaining multi-planar scans with isotropic resolution
using a 64-channel CT system.

Inclusion Criteria:

- Persons 50 years or older with recently diagnosed diabetes (within 2 years), with at
least one of the following: no family history of diabetes, abdominal discomfort,
anorexia, weight loss, elevated serum CA 19-9, or those undergoing EUS with or
without Fine Needle Aspiration (FNA) for pancreatic cancer screening ; OR

- Persons 35 years old or older with familial pancreatic cancer with 2 or more first
degree relatives with pancreatic cancer; OR

- Persons 35 years old or older with Peutz-Jeghers syndrome; OR

- Persons 35 years old or older with suspicious clinical symptoms of pancreatic cancer,
but had normal CT of the abdomen with iodinated contrast within 2 weeks.

Exclusion Criteria:

- Persons with contraindication to iodinated contrast

- Allergy to iodinated contrast

- Renal insufficiency (serum creatinine > 1.5 mg/dl)

- Patients with contraindication to ionizing radiation

- Pregnancy

- Patients with previous pancreatic surgery

- Contraindication to secretin

- Allergy to secretin

- Acute pancreatitis