scholarly journals STUDY OF SERUM LIPASE TO AMYLASE RATIO IN DIFFERENTIATING BETWEEN ACUTE ALCOHOLIC AND NON-ALCOHOLIC PANCREATITIS

2020 ◽  
pp. 1-2
Author(s):  
Sudhansu Sarkar ◽  
Bala Krishna Havligi
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Imaging Modality ◽  
Severe Disease ◽  
Treatment Protocol ◽  
Fold Increase ◽  
Alcoholic Pancreatitis ◽  
Serum Lipase ◽  
Gall Stones ◽  
Overall Mortality

Acute pancreatitis (AP) is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain in abdomen.(4) Gall stones and alcoholism together account for 80% of acute pancreatitis.(5) Although the overall mortality rate for acute pancreatitis is 2-10% and this is primarily related to the 10-30% of patients with severe disease characterized by pancreatic and peripancreatic necrosis.(6) Diagnosis remains clinical and can be supported by 1.5 - 2 fold increase above the upper limit of normal of serum amylase and lipase.(10) Amylase and lipase levels are known to be the most important factors in determining acute pancreatitis. It is well known that these levels are usually elevated in acute pancreatitis, without regard to whether it is of biliary type or alcoholic type. Furthermore whether or not these levels can be used to discern between the two types, has been also a matter of concern. It has been reported that the lipase/amylase ratio could be a new index distinguishing two types of pancreatitis, with the critical value being 2. This report had been followed by some debate between supporters and opponents. Currently CECT is the imaging modality of choice where areas of hypo perfusion correlate with necrosis. (11) It can’t differentiate between alcoholic and non-alcoholic AP. Identification of two groups could help formulating treatment protocol for either group. The aim of the present study is to establish the utility of the ratio of the serum lipase and serum amylase, a new index distinguishing acute episode of alcoholic from non alcoholic pancreatitis.

scholarly journals The role and importance of biochemical markers in diagnosis of alcoholic acute pancreatitis

2012 ◽  
Vol 65 (3-4) ◽  
pp. 152-157
Author(s):  
Snezana Tesic-Rajkovic ◽  
Biljana Radovanovic-Dinic ◽  
Tatjana Jevtovic-Stoimenov
Keyword(s):  
Acute Pancreatitis ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Biochemical Markers ◽  
Biochemical Parameters ◽  
Serum Amylase ◽  
Alcoholic Pancreatitis ◽  
Serum Lipase ◽  
Acute Alcoholic Pancreatitis ◽  
Biochemical Analyses

Introduction. Alcoholic acute pancreatitis occurs in 10% of alcoholics, who take more than 80g alcohol daily. Different biochemical markers are used to diagnose acute pancreatitis, and some of them may help in establishing etiology of acute pancreatitis. Material and Methods. This study is a prospective review of 21 patients. All patients were hospitalized at the Department for Gastroenterology and Hepatology or at the Department for Surgery of the Clinical Centre of Nis in the period from August 1st 2009 to March 1st 2010 with diagnosis of acute alcoholic pancreatitis. Detailed anamnesis, clinical examination, biochemical analyses and ultrasonography of the upper abdomen were done in all patients. All patients provided data on alcohol abuse. Results. The analysis of the corresponding biochemical parameters revealed a statistically significant correlation between the following values: serum amylase and serum lipase (R=0.964674; p<0.001), cholesterol and triglycerides (R=0.93789; p<0.001), total and direct bilirubin (R=0.857899; p<0.001) and between aspartate aminotransferase and alanine aminotransferase (R=0.824461, p<0.001) in patients with alcoholic acute pancreatitis. In addition, there was a statistically significant correlation between the values of serum amylase and urinary amylase (R=0.582742, p<0.001). Discussion. The analysis of biochemical markers showed that some of them were significant for beforehand diagnosis of alcoholic acute pancreatitis, which is in accordance with other studies. Conclusion Some biochemical parameters can be potential predictors of alcoholic acute pancreatitis (lipase/amylase ratio >2, greater ratio of aspartate aminotransferase/ alanine aminotransferase, enhanced triglycerides and values of mean corpuscular volume.

scholarly journals Clinical pattern of acute pancreatitis in eastern India and comparison of Ranson, BISAP and APACHE II as a predictor of severity, local complications and mortality

2018 ◽  
Vol 5 (11) ◽  
pp. 3707 ◽  
Author(s):  
Nishith M. Paul Ekka ◽  
Gaurav Mishra ◽  
Vinod Kumar ◽  
Arun Kumar Tiwary ◽  
Tanushree Kar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Hospital Admissions ◽  
Scoring Systems ◽  
Apache Ii ◽  
Aetiological Factor ◽  
Serum Lipase ◽  
Clinical Pattern ◽  
Local Complications ◽  
Complications And Mortality

Background: Acute pancreatitis is the single most frequent gastrointestinal cause of hospital admissions. Scoring systems have been used since the 1970s for assessment of its severity. This study was aimed to assess the clinical pattern of acute pancreatitis and to compare various predicting systems like Ranson, BISAP and APACHE II in predicting severity, local complications and mortality in acute pancreatitis.Methods: In this prospective study, 91 consecutive cases of acute pancreatitis admitted, between April 2015 to March 2017, were studied. The diagnostic criteria include the presence of at least two of the three features; abdominal pain, serum amylase and lipase levels and findings on imaging studies. Patients were divided into two groups each, BISAP Ranson ≥3 and <3, APACHE II ≥8 and <8, and analyzed statistically.Results: Out of total of 91 patients, 81 were male and 14 were female with mean age was 36.14 years. Commonest aetiological factor was alcoholism in 57.89% followed by gallstones in 23.16%. Serum amylase was raised in 83.26% patients while 95.79% had raised serum lipase levels. 75.79% patients were of MAP while 24.21% patients were of MSAP and SAP. 7.37% patients developed local complications and mortality rate was 6.32%. All the scoring systems were found similar in predicting severity, local complication and mortality, had low sensitivity and high specificity (P value < 0.05).Conclusions: There is no ideal predicting system for acute pancreatitis. These scoring systems can be used to triage patients for better healthcare delivery.

CAPD and Pancreatitis: No Connection

1992 ◽  
Vol 12 (3) ◽  
pp. 309-316 ◽  
Author(s):  
Amit Gupta ◽  
Zheng Vuan ◽  
Elias V. Balaskas ◽  
Ramesh Khanna ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Pancreatic Secretory Trypsin Inhibitor ◽  
Serum Lipase ◽  
High Index Of Suspicion ◽  
Acute And Chronic Pancreatitis ◽  
Symptoms And Signs ◽  
Capd Patient ◽  
Uncommon Complication

Autopsy studies have shown that approximately 56% of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) develop various pancreatic abnormalities, such as acute and chronic pancreatitis, fibrosis, and acinar dilatation. This prevalence of anatomical abnormalities is similar to that observed in patients on hemodialysis and higher than that in those with normal renal function. However, clinical acute pancreatitis is an uncommon complication of CAPD (0.9%), and this prevalence is similar to that (1.7%) of patient son hemodialysis. We can attribute acute pancreatitis in CAPD patients to no single factor. Perhaps preexisting anatomical abnormalities of the pancreas make the CAPD patient susceptible to acute pancreatitis when exposed to a variety of physiological and non physiological influences. The diagnosis of acute pancreatitis in CAPD patients is difficult, because symptoms and signs are similar to those of dialysis-associated peritonitis. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100 U/L suggest the diagnosis of acute pancreatitis. Serum lipase, isoamylase, and pancreatic secretory trypsin inhibitor are not helpful. In confirming the diagnosis, a computed tomography (CT) scan is more helpful than ultrasound, although it is positive in only 50–60% of cases. One should harbor a high index of suspicion concerning acute pancreatitis if a CAPD patient presenting with suspected peritonitis has either a negative effluent culture or does not respond to antibiotic therapy.

scholarly journals Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy

2016 ◽  
Vol 59 (3) ◽  
pp. 84-90 ◽  
Author(s):  
Marcela Kopáčová ◽  
Jan Bureš ◽  
Stanislav Rejchrt ◽  
Jaroslava Vávrová ◽  
Jolana Bártová ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Double Balloon Enteroscopy ◽  
Serum Lipase ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Laboratory Markers ◽  
Before And After ◽  
Hs Crp ◽  
Urine Amylase

Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

scholarly journals A retrospective study of clinical efficacy of serum lipase/amylase ratio in predicting etiology of acute pancreatitis

2018 ◽  
Vol 5 (4) ◽  
pp. 1365
Author(s):  
Harish Kumar C. ◽  
Mridul G. S.
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Serum Amylase ◽  
Imaging Techniques ◽  
Group Versus ◽  
Amylase Level ◽  
Serum Lipase ◽  
Serum Amylase Level ◽  
Alcohol Group ◽  
Male Predominance

Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of pancreatitis, the efficacy to predict the etiology of acute pancreatitis is assessed in our study as it may need different therapeutic approaches.Methods: From January 2017 to December 2017, 54 patients with acute pancreatitis were included 48 (88.9%) men and 6 (11.1%) women with a mean age of 39.2 years, ranging from 18 to 90 years. They were divided into 2 subgroups as alcohol (n=27), nonalcoholic (n=27), and their serum L/A ratio level were compared with a mean age 39.42±9.9 years in alcoholic group versus 39.04 ± 7.7 years in nonalcoholic group.Results: Male predominance in alcoholic and nonalcoholic group and all female patients (100%) etiology is nonalcoholic. The elevation of serum amylase level in nonalcoholic group on average is 600 versus in alcoholic group 512 and serum lipase level average in nonalcoholic group 766 versus in alcohol group 629. Instead, the serum L/A ratio showed no significant changes among each group. In this study, the alcoholic acute pancreatitis is more severe than nonalcoholic pancreatitis. There was also no statistically significant (p=0.90) difference in serum L/A ratio in alcoholic and nonalcoholic pancreatitis.Conclusions: The serum amylase and lipase concentrations are not able to establish etiology acute pancreatitis as assessed by imaging techniques. The L/A ratio is not a good predictive factor in distinguishing acute episode of alcoholic and non-alcoholic acute pancreatitis.

scholarly journals TO STUDY THE INCIDENCE OF GALL STONE PANCREATITIS AND ALCOHOLIC PANCREATITIS OUR INSTITUTION

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Ravindra Singh ◽  
Devendra Singh
Keyword(s):  
Acute Pancreatitis ◽  
Risk Factor ◽  
Alcohol Abuse ◽  
Biliary Tract ◽  
Gall Stone ◽  
Stone Disease ◽  
Alcoholic Pancreatitis ◽  
Equal Frequency ◽  
Medical College ◽  
Gall Stones

Background: The most important aetiological factors for acute pancreatitis are either biliary tract stone disease or alcohol, which account for approximately 75-80% of all cases of acute pancreatitis Methods: This study was conducted in the department of surgery, RNT Medical College and Maharana Bhupal Govt. Hospital, Udaipur. A total of 35 cases of acute pancreatitis were studied Results: In our study of 35 cases of acute pancreatitis, 14(40%) patient had alcoholic pancreatitis, and 13(37.2%) patient had gall stone pancreatitis. Conclusion: Prevalence of Alcohol abuse and gall stones were almost equal frequency. Keywords: Risk factor, Pancreatitis, Gall sone

PREDICTING THE COURSE OF ACUTE PANCREATITIS PATIENT BASED ON HARMLESS ACUTE PANCREATITIS SCORE (HAPS)

2021 ◽  
pp. 59-62
Author(s):  
Shivani Manoj ◽  
Jayant Kumar Banerjee
Keyword(s):  
Acute Pancreatitis ◽  
Scoring System ◽  
Serum Amylase ◽  
Research Centre ◽  
Common Disease ◽  
Serum Lipase

INTRODUCTION: Acute pancreatitis is a common disease with a very unpredictable course , and hence requires a scoring system that is easy, quick and simple and that can predict the course at the earliest to avoid and prevent further complications. One such scoring system in recent times is the Harmless Acute Pancreatitis Score. MATERIALS AND METHODS: 60 patients presenting with pain in abdomen with raised serum amylase and serum lipase level are admitted to Bharati Hospital and research centre, Pune. DISCUSSION: Harmless Acute Pancreatitis score could predict the severe cases more efciently and that helped in making necessary decisions and improving the line of management. As per our study, we found the Harmless Acute Pancreatitis score to be an effective scoring system in predicting the course of Acute Pancreatitis with least number of investigations and requiring not more than half an hour. CONCLUSION:The Harmless Acute Pancreatitis Score is a good prognostic scoring system in predicting severe cases more efciently than mild cases very early on admission, requiring least number of investigations

Serum Lipase Amylase Ratio in Predicting Aetiology, Severity and Outcome of Acute Pancreatitis in a Tertiary Care Hospital

2017 ◽  
Vol 5 (2) ◽  
pp. 88-92
Author(s):  
Majharul Haque ◽  
Golam Azam ◽  
Debashis Kumar Sarkar ◽  
Anisur Rahman
Keyword(s):  
Acute Pancreatitis ◽  
Sensitivity And Specificity ◽  
Severe Acute Pancreatitis ◽  
Alcoholic Pancreatitis ◽  
Care Hospital ◽  
Biliary Pancreatitis ◽  
Serum Lipase ◽  
Arterial Blood ◽  
Function Test ◽  
Acute Alcoholic Pancreatitis

Background: Acute pancreatitis is a relatively common disease with variable prevalence in different countries. Different modalities are available for predicting aetiology, severity and outcome of acute pancreatitis with different sensitivity and specificity. Moreover, some are not widely available, some are very expensive. A single, cheap, widely available marker with high sensitivity and specificity is yet to be identified. The present study intends to find out the utility of serum lipase amylase ratio in predicting the aetiology, severity and outcome of acute pancreatitis.Methods: This prospective, observational study was done at the Department of Gastrointestinal Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM General Hospital, Dhaka, during the period of July 2014 to March 2016. A total of 71 patients with acute pancreatitis were included. Complete blood count, serum amylase, serum lipase, serum calcium, liver function test, renal function test, fasting lipid profile, ultrasonography of whole abdomen, CT scan of upper abdomen and arterial blood gas (ABG) were done in all patients. Statistical analysis was done with SPSS version 16.Results: Among 71 patients, 23(32.4%) were due to biliary cause, 15(21.1%) were due to hypertriglyceridaemia, 4(5.6%) were due to alcohol and 22(31%) were due to unknown causes. 45 (63.4%) patients had mild attack, 10(14.1%) patients had moderate attack and 16(22.5%) patients had severe attack of acute pancreatitis. Out of 71 patients, 17(23.9%) developed complication whereas 54(76.1%) developed no complication. Serum lipase amylase ratio in patients with biliary pancreatitis was 1.40±0.39 and in patients with non-biliary pancreatitis was 2.39±0.84(p <0.001). Again, serum lipase amylase ratio in patients with acute alcoholic pancreatitis was 2.89±0.79 and in patients with non-alcoholic acute pancreatitis was 1.95±0.81 (p=0.002). Serum lipase amylase ratio in patients with acute pancreatitis due to hypertriglyceridaemia was 2.75±0.68 and in patients with acute pancreatitis due to other than hypertriglyceridaemia was 1.62±.65(p< 0.001). This study showed that serum lipase amylase ratio was <2.0 in acute biliary pancreatitis and this ratio was >2.5 in acute alcoholic pancreatitis and in acute pancreatitis due to hypertriglyceridaemia. Serum lipase amylase ratio in patients with mild acute pancreatitis was 1.95±0.89; in patients with moderately severe acute pancreatitis the ratio was 2.37±0.92 and in patients with severe acute pancreatitis, the ratio was 2.22±0.70. The difference of lipase amylase ratio among these groups of patients was not statistically significant (p=0.273). Mean lipase amylase ratio among the patients without complication of acute pancreatitis was 2.03±0.92 whereas this ratio among the patients with complication was 2.17±0.68. This difference of lipase amylase ratio was not statistically significant (p=0.557).Conclusion: Role of serum lipase amylase ratio in predicting the aetiology and severity of acute pancreatitis has been addressed in several recent studies. This study was another attempt to achieve this goal. Predicting the aetiology of acute pancreatitis by such a cheap tool will guide further diagnostic work up and management strategy will avoid unnecessary investigations.Bangladesh Crit Care J September 2017; 5(2): 88-92

scholarly journals The Role of Routine Assays of Serum Amylase and Lipase for the Diagnosis of Acute Abdominal Pain

2009 ◽  
Vol 91 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Paul A Sutton ◽  
David J Humes ◽  
Gemma Purcell ◽  
Janette K Smith ◽  
Frances Whiting ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Serum Amylase ◽  
Reference Range ◽  
Acute Abdominal Pain ◽  
Clinical Suspicion ◽  
University Teaching ◽  
Data Set ◽  
Serum Lipase

INTRODUCTION We aimed to evaluate the role of routine measurements of serum amylase and lipase in the diagnosis of acute abdominal pain. PATIENTS AND METHODS We identified all patients who had serum amylase and lipase assays over a 62-day period at a single university teaching hospital and reviewed their case notes. RESULTS We excluded 58 of the 1598 patients on grounds of ineligibility (< 18 years of age and those transferred from other hospitals). A complete data set was obtained for 1520 (98.7%) of the remaining 1540 patients. Only 9.1% of requests were based on a clinical suspicion of acute pancreatitis. Of the 44 (2.9%) patients who had acute pancreatitis, only 28 (63.6%) had an associated rise in serum amylase and/or lipase 3 times above the maximum reference range, the remainder being diagnosed radiologically. At this cut-off range, the sensitivity and specificity for serum amylase were 50% and 99%, and those for serum lipase 64% and 97%, respectively. CONCLUSIONS Routine measurements of serum amylase and lipase are unhelpful in the diagnosis of acute abdominal pain unless there is clinical suspicion of acute pancreatitis. In these patients, assay of lipase alone is preferable to assay of amylase alone or both enzymes.

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