scholarly journals Sensitivity and Specificity of Urine Trypsinogen 2 Dip Test in Acute Upper Abdominal Pain for the Diagnosis of Acute Pancreatitis

2022 ◽  
Vol 5 (1) ◽  
pp. 31-35
Author(s):  
Punitkumar Patel ◽  
Arun Bahulikar ◽  
Nandakumar Beke ◽  
Divya Patel ◽  
Deepak Phalgune
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Sensitivity And Specificity ◽  
Upper Abdominal ◽  
Dip Test

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

Acute pancreatitis

2010 ◽  
pp. 2557-2567
Author(s):  
R. Carter ◽  
C.J. McKay
Keyword(s):  
Acute Pancreatitis ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Abdominal Pain ◽  
Serum Amylase ◽  
Perforated Peptic Ulcer ◽  
Upper Limit ◽  
Abdominal Emergencies ◽  
Idiopathic Acute Pancreatitis ◽  
Upper Abdominal

Acute pancreatitis affects 300 to 600 new patients per million population per year and is most commonly caused by gallstones or alcohol, but there are many other causes and associations. Careful imaging reveals that most so-called idiopathic acute pancreatitis is due to small (1–3 mm diameter) gallstones. Diagnosis is made by a combination of a typical presentation (upper abdominal pain and vomiting) in conjunction with raised serum amylase (> × 3 upper limit of normal) and/or lipase (> × 2 upper limit of normal). Several acute abdominal emergencies can mimic acute pancreatitis and may be associated with a raised serum amylase. These include perforated peptic ulcer (particularly perforated posterior gastric ulcer) and acute mesenteric ischaemia. In equivocal cases, a CT scan is indicated in order to exclude other causes and confirm the diagnosis....

The utility of point-of-care urine trypsinogen dipstick test for diagnosing acute pancreatitis in an emergency unit

2021 ◽  
Author(s):  
Amar Simha ◽  
Atul Saroch ◽  
Ashok K Pannu ◽  
Deba P Dhibar ◽  
Navneet Sharma ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Pain Sensitivity ◽  
Point Of Care ◽  
Emergency Unit ◽  
Dipstick Test ◽  
Low Sensitivity

Background: A point-of-care diagnostic test for acute pancreatitis could help in early triage and management of this condition. Materials & methods: Urine trypsinogen dipstick test (UTDT) was performed in consecutive cases suspected to have acute pancreatitis and diagnostic accuracy calculated. Results: Of 187 patients, 90 were have acute pancreatitis and UTDT was positive in 61 (67.7%). In the 97 non pancreatitis cases, UTDT was positive in nine (9.3%). The sensitivity and specificity of UTDT for acute pancreatitis was 67.8% and 90.7%, respectively. In patients presenting within 3 days of abdominal pain, sensitivity and specificity were 72.7% and 91.8%, respectively. Discussion: While offering the possibility of a point of care diagnosis, the low sensitivity of UTDT could be a concern with its routine use.

Pseudohyponatraemia caused by acute pancreatitis–derived hypertriglyceridaemia

2021 ◽  
Vol 14 (4) ◽  
pp. e241806
Author(s):  
Rasmus Søgaard Hansen ◽  
Jesper Revsholm ◽  
Mohammad Motawea ◽  
Lars Folkestad
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
General Practitioner ◽  
Ct Scan ◽  
Plasma Sodium ◽  
Haemoglobin A1c ◽  
Local Hospital ◽  
Severe Hyponatraemia ◽  
Upper Abdominal ◽  
Venous Plasma

We report a case of pseudohyponatraemia due to severe hypertriglyceridaemia-induced acute pancreatitis, stemming from unknown diabetes. A woman in her late 30s was admitted to the local hospital by her general practitioner due to severe hyponatraemia (116 mmol/L) and upper abdominal pain. At admission to the hospital, there was a discrepancy of 19 mmol/L between arterial and venous sodium, along with severe hypertriglyceridaemia and hypercholesterolaemia. Pancreatitis was diagnosed using a CT scan. The patient received plasmapheresis which significantly reduced triglycerides, and venous plasma sodium was normalised indicating pseudohyponatraemia at admission. Finally, a haemoglobin A1c of 83 mmol/mol was found. Diabetes was diagnosed, and insulin was initiated.

scholarly journals A Case of Syncope Induced in the Supine Position

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Kazuo Eguchi ◽  
Akihiro Tsujita ◽  
Syoji Ono ◽  
Kazuomi Kario
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Liver Tumor ◽  
Supine Position ◽  
Metastatic Liver Tumor ◽  
History Of ◽  
Underlying Mechanisms ◽  
Upper Abdominal ◽  
Metastatic Liver

We experienced a reproducible supine syncope followed by upper abdominal pain. A 66-year-old man was transferred to our hospital after an episode of syncope during sleep. He had a history of acute pancreatitis, diabetes, hypertension, and dyslipidemia, but no history of presyncopal attack. One night, his wife noticed he was snoring abnormally in bed, and he did not respond to her voice until after she tried many times to wake him. The same attack was reproduced three times in the same situation. One of the attacks was recorded under a continuous ECG and radial tonometry. In this case, a presyncopal attack and a sense of ill-feeling were provoked by the patient lying in a prolonged supine position. He was eventually diagnosed as metastatic liver tumor 5 months after the first attack. Because few cases of syncopal attack have been reported in the supine position, its underlying mechanisms deserve consideration.

scholarly journals Ascaris infection, a rare cause of necrotizing pancreatitis in a child

2020 ◽  
Vol 10 (1) ◽  
pp. 88-90
Author(s):  
Aditya Prakash Yadav ◽  
Rishi Kumar Karki ◽  
Binod Kumar Rai
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Necrotizing Pancreatitis ◽  
Exploratory Laparotomy ◽  
Mortality Rates ◽  
High Morbidity ◽  
Provisional Diagnosis ◽  
Intraoperative Diagnosis ◽  
Biliary Ascariasis ◽  
Upper Abdominal

Necrotizing pancreatitis is a very rare in children and is associated with high morbidity & mortality rates. We report a case of 5yr old boy who presented with upper abdominal pain, vomiting and non-passage of stool for 1day. After resuscitation and investigating the child, a provisional diagnosis of biliary ascariasis (BA) with acute pancreatitis was made. The child developed peritonitis after 2 days of admission and exploratory laparotomy was planned. An intraoperative diagnosis of necrotizing pancreatitis was made and the child was successfully managed.

scholarly journals Hypercalcemia induced pancreatitis as a rare presentation of primary hyperparathyroidism

2021 ◽  
Vol 84 (2) ◽  
pp. 367-370
Author(s):  
V Desmedt ◽  
S Desmedt ◽  
E D’heygere ◽  
G Vereecke ◽  
W Van Moerkercke
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Inflammatory Process ◽  
High Morbidity ◽  
Rare Presentation ◽  
Common Cause ◽  
Upper Abdominal

Acute pancreatitis (AP) is an inflammatory process of the pancreas. It is a relatively common cause of acute upper abdominal pain and is potentially associated with high morbidity and mortality. Underlying hypercalcemia as a cause of AP is very rare. We present a case of a hypercalcemia-induced acute pancreatitis with an underlying parathyroid adenoma in an 81-year-old woman with no previous symptoms of hypercalcemia. The parathyroid adenoma was semi-urgently surgically resected with normalization of calcium-levels. This case report summarizes the causes of acute pancreatitis and hypercalcemia and its management.

Spontaneous intramural duodenal hematoma in a young woman

2021 ◽  
Vol 75 (6) ◽  
pp. 535-539
Author(s):  
Petra Vrbová ◽  
Tomáš Koller
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Key Words ◽  
Clinical Symptoms ◽  
Supportive Therapy ◽  
Gastrointestinal Obstruction ◽  
History Of ◽  
Duodenal Hematoma ◽  
Upper Abdominal

Summary: Non-traumatic spontaneous intramural duodenal hematoma is a rare cause of proximal gastrointestinal obstruction which may present with hemorrhage, jaundice and pancreatitis. In this case report we present a case of spontaneous duodenal hematoma in a 28-year-old female with a history of acute pancreatitis, admitted to hospital for convulsive upper abdominal pain with vomiting as suspected pancreatitis. An MRI examination of the abdomen confi rmed intraluminal bleeding into the duodenum. Following supportive therapy the clinical symptoms spontaneously subsided and laboratory parameters improved. Due to early dia gnosis and therapy the patient had a good outcome, without requiring surgery. Repeated imaging showed hematoma resorption. Key words: abdominal pain – vomitus – duodenal hematoma – hemorrhage

scholarly journals Acute pancreatitis in pregnancy: 5-year experience from a multidisciplinary centre

2018 ◽  
Vol 7 (2) ◽  
pp. 546
Author(s):  
Saranya Srikumar ◽  
Sobha S. Nair ◽  
Reshma Reghunath ◽  
Sharanya Raj ◽  
Radhamany K.
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Pregnant Women ◽  
Gestational Age ◽  
Fetal Outcome ◽  
Diagnostic Methods ◽  
Fetal Mortality ◽  
The Mean ◽  
Upper Abdominal ◽  
In Pregnancy

Background: Acute pancreatitis is rare in pregnancy, but it is associated with increased incidence of maternal and fetal mortality. It should be one of the differential diagnosis of upper abdominal pain with or without nausea or vomiting. S. amylase, lipase and ultrasound abdomen were the diagnostic methods. Conservative management is the main stay in mild cases. Severe cases have multiorgan involvement and needs multidisciplinary approach. The objectives of this study were to study the maternal and fetal outcome in pregnant women diagnosed with acute pancreatitis and to identify the risk factors for acute pancreatitis in pregnancy.Methods: Retrospective descriptive study of pregnant women diagnosed with acute pancreatitis in Amrita Institute of Medical Sciences, Kochi during the period of 5 years from January 2011 to December 2016. A proforma having patients age, parity index, gestational age, symptoms with duration, blood investigations, ultrasonography, interventions done, mode of delivery, supportive treatment, complications were developed. Fetal weight, Apgar score, fetal complications were also noted.Results: The mean gestational age of presentation was 30 weeks of pregnancy. Upper abdominal pain radiating to back, vomiting, fever was the commonest clinical presentation in majority of cases. The diagnostic methods were S.Amylase ,Lipase and Ultrasound abdomen. The mean age of the patients were 26 years and 66.7% were primigravidas in the present study. There were 4 patients in SAP and 5 in MAP groups. Complications in SAP group were ARF, ARDS, DIC, MODS, metabolic acidosis etc. SAP group had 3 maternal and 3 fetal loss.Conclusions: Severe acute pancreatitis has adverse maternal and fetal outcome due to multi organ failure and sepsis.

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

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