Diagnosis of fat absorption with 14C-tripalmitate/3H-palmitic acid.

In 44 normal subjects, in 89 patients with chronic pancreatitis, of whom 23 had elevated faecal fat, and in 19 patients with various diseases of the small gut investigations with 14C-tripalmitate and 3H-palmitic acid, dissolved in 1.0 g Indian corn oil/kg, were performed. Serum lipid activity of 14C and 3H was measured 4, 6, and 8 h later. Compared with absolute values of triglyceride absorption (percentage dose of 14C-lipid activity/l serum), relative values (14C/3H ratio of the serum lipids) led to a significantly better discrimination between the control group and patients, attributable to a much smaller normal range. Compared with fatty acid absorption, triglyceride absorption was lowered in all cases of pancreatic steatorrhoea, in most cases of chronic pancreatitis, and in some cases of intestinal malabsorption. While the proposed procedure seems to be sensitive and reliable in the detection of maldigestion, a distinction between maldigestion and malabsorption is apparently uncertain.