scholarly journals A Rare Case: Gall Stone Induced Acute Pancreatitis with Normal Amylase and Lipase Levels

2020 ◽  
Vol 3 (2) ◽  
pp. 10-12
Author(s):  
Arindam Mukherjee ◽  
Govind Madhav ◽  
Ajay Tadha
Keyword(s):  
Acute Pancreatitis ◽  
Rare Case ◽  
Serum Amylase ◽  
Gall Stone ◽  
Clinical Suspicion

Acute pancreatitis (AP) is most commonly diagnosed by increased values of serum amylase and lipase. Acute pancreatitis where value of serum amylase and lipase is normal is very rare. This is a case of gall stone induced AP where levels of serum amylase and lipase are normal but the clinical suspicion and imaging are strongly confirming pancreatitis.

scholarly journals Acute Pancreatitis with Normal Amylase: A Case Report

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jinous Manouchehri ◽  
Yadollah Rashidi
Keyword(s):  
Acute Pancreatitis ◽  
Laboratory Tests ◽  
Diagnostic Method ◽  
Serum Amylase ◽  
Clinical Signs ◽  
Rapid Diagnosis ◽  
Clinical Suspicion ◽  
Diagnostic Methods ◽  
Therapeutic Outcomes

: Rapid diagnosis in patients with acute pancreatitis is essential to optimal therapeutic outcomes. Upon clinical suspicion, various methods could be used to confirm the diagnosis based on the symptoms and examinations. Laboratory tests are an important diagnostic method in this regard based on the increased serum amylase/lipase. In this study, we described the case of a 31-year-old male patient presenting with the clinical signs of pancreatitis with normal amylase and elevated triglyceride in the follow-up. In case of strong clinical suspicion, other tests and diagnostic methods are recommended to confirm acute pancreatitis.

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.

scholarly journals Role of Biochemical Investigation in Prediction of Biliary Etiology in Acute Pancreatitis

2013 ◽  
Vol 52 (189) ◽  
pp. 229-232 ◽  
Author(s):  
Tanka Prasad Bohara ◽  
Anuj Parajuli ◽  
Mukund Raj Joshi
Keyword(s):  
Acute Pancreatitis ◽  
Liver Function ◽  
Liver Function Test ◽  
Serum Amylase ◽  
Gall Stone ◽  
Abdominal Ultrasound ◽  
Stone Disease ◽  
Amylase Level ◽  
Biliary Pancreatitis ◽  
Function Test

Introduction: Acute pancreatitis is common clinical resentation. Gall stone disease and alcohol consumption are most common etiologies. Detection of biliary etiology is important in order to provide definite management in form of cholecystectomy to prevent further attacks. Sensitivity for abdominal ultrasound to detect cholelithiasis is decreased to 67–87% in presence of acute pancreatitis. Difference in biochemical investigations of acute biliary and non-biliary pancreatitis has been proposed to increase the suspicion of biliary etiology. Methods: Sixty patients admitted with diagnosis of acute pancreatitis from March 2012 to December 2012 were included in the study. The relation between etiology with age, sex, admission serum amylase and liver function test were evaluated. Results: Out of 60 patients 38 (63.33%) and 22 (36.66%) had biliary and non-biliary etiology respectively. Biliary pancreatitis was more common in females (25 vs. 3). Distribution of severity was comparable between both groups. Biliary pancreatitis group had significantly higher amylase level (3466.42 vs. 1987.5, p 0.003) whereas values of liver function test were higher in biliary pancreatitis though not statistically significant. Conclusions: A simple, rapid and accurate prediction of biliary etiology of acute pancreatitis can be provided by changes in biochemical parameters. Keywords: Acute Pancreatitis; Biliary Pancreatitis; Serum Amylase.  

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

Restoration of intestinal mucosal in Euphorbia kansui-treated severe acute pancreatitis rats is based on HMGB1/MFG-E8 expression

2020 ◽  
Vol 21 ◽  
Author(s):  
Chengjiang Qiu ◽  
Kairui Liu ◽  
Xuguang Li ◽  
Weirun Chen ◽  
Sheng Zhang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Serum Amylase ◽  
Intestinal Barrier ◽  
Enzyme Linked Immunosorbent Assay ◽  
Inflammatory Factor ◽  
Apoptotic Cells ◽  
Rat Ileum ◽  
Plasma Endotoxin ◽  
Euphorbia Kansui

Background: The pathogenesis of severe acute pancreatitis (SAP) is mediated substantially by dysfunctions in the intestinal barrier. Euphorbia kansui (EK) is a medicinal plant used widely in traditional Chinese medicine to treat inflammation; however, its efficacy and mechanism of action in SAP treatment is not yet well understood. Objective: To investigate the role of EK in intestinal barrier tissue repair and in the pathogenesis and development of SAP. Methods: The rat SAP model was established by a retrograde injection of sodium taurocholate into the pancreatic bile duct. The SAP model group and the SAP + EK treatment groups were divided into 6 subgroups according to timing: 2, 6, 12, 24, 48, or 72 h after inducing SAP. The progression of the SAP rats and of the rats receiving the EK treatment was evaluated using the ascites volume, serum amylase and plasma endotoxin levels, and histological grading of intestinal mucosal damage. In addition, serum inflammatory factor contents were measured using enzyme-linked immunosorbent assay (ELISA) tests and apoptotic cells in damaged ileum tissue were detected using TUNEL staining. Apoptosis markers and other signaling proteins in intestinal mucosal cells were detected by immunohistochemical assays and then validated by combining these data with quantitative polymerase chain reactions and western blotting. Results: Compared with the results of the SAP model rats, the results of the rats that received EK treatment demonstrated that EK could effectively reduce the ascites volume and serum amylase and plasma endotoxin levels. EK treatment also greatly reduced the abnormal intestinal morphological alterations in the rat SAP model and significantly downregulated the serum contents of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α. EK treatment inhibited the elevation of capapse-3, inhibited the decrease of the Bcl-2 protein, and decreased the number of apoptotic cells in rat ileum tissue. Finally, EK treatment abrogated the increase of HMGB1 and the suppression of MFG-E8 protein expression in the SAP + EK rat ileum tissue. Conclusion: EK suppresses SAP pathogenesis by restoring intestinal barrier function and modulating the HMGB1/MFG-E8 signaling axis.

scholarly journals Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Christina S. Chen-Milhone ◽  
Kalyan Chakravarthy Potu ◽  
Sudhir Mungee
Keyword(s):  
Tricuspid Valve ◽  
Right Atrium ◽  
Rare Case ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Clinical Suspicion ◽  
Ventricular Rate ◽  
Immunocompromised Patients ◽  
Transthoracic Echocardiogram ◽  
The Right

Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

scholarly journals Acute Pancreatitis Secondary to an Incarcerated Paraoesophageal Hernia: A Rare Cause for a Common Problem

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13079 ◽  
Author(s):  
Kathryn Boyce ◽  
William Campbell ◽  
Mark Taylor
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Pancreatic Duct ◽  
Rare Case ◽  
Open Repair ◽  
Pancreatic Head ◽  
Good Recovery ◽  
Type Iv ◽  
Rare Case Report ◽  
Paraoesophageal Hernia

This is a rare case report of acute pancreatitis secondary to a massive incarcerated paraoesophageal hernia. The pathogenesis resulted from obstruction of the distal pancreatic duct after displacement of the pancreatic head and body into the thorax as part of a Type IV paraoesophageal hernia. Although this condition is rare, the patient made steady progress following laparotomy and open repair of hernia. She made a good recovery after prompt therapy, therefore, this report can be a guide to the diagnosis and treatment of similar conditions.

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.

Bone Marrow Mesenchymal Stem Cells (BMSCs) Transplantation Alleviates Acute Pancreatitis Through Inhibiting Inflammation and Promoting Caspase-8 Apoptosis Pathway

2022 ◽  
Vol 12 (5) ◽  
pp. 1034-1039
Author(s):  
Xiaoxiang Wang ◽  
Lan Yu ◽  
Xing Xiong ◽  
Yao Chen ◽  
Bo Men
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Acute Pancreatitis ◽  
Mesenchymal Stem Cells ◽  
Serum Amylase ◽  
Inflammatory Factors ◽  
Control Group ◽  
Caspase 8 ◽  
Apoptosis Pathway ◽  
Marrow Mesenchymal Stem Cells

Bone marrow mesenchymal stem cells (BMSCs) are capable of multipolar differentiation and repairing injured tissues. Herein, we aimed to investigate the mechanism by how BMSCs modulate the apoptotic pathway in the acute pancreatitis (AP). In this study, primary BMSCs were cultured and administrated into 10 AP mice while 10 healthy mice were taken as a blank group and 10 AP mice as a control group. The mouse pancreatic tissues were assessed by HE staining and evaluated by pancreatitis score and serum amylase detection. Level of inflammatory factors CRP and TNF-α was measured by ELISA and PIPK1, PIPK3, MLKL and Caspase-8 expression was detected by RT-qPCR and Western blot. The pancreatitis score (7.29±1.36) and the serum amylase score of (453.66±103.67) mu/ml of BMSCs group was significantly higher than that of control group, indicating increased tissue repair after BMSCs treatment. BMSCs group exhibited a higher level of CRP (711.01±115.31) and TNF-α (132.81±22.13) in serum compared to control group (p < 0.05). PIPK1, PIPK3, and MLKL expression in BMSCs group decreased (p < 0.05) whereas Caspase-8 was increased (p < 0.05). On the other hand, BMSCs group presented upregulated PIPK1, PIPK3, and MLKL (p < 0.05) and downregulated Caspase-8 (p < 0.05). In conclusion, BMSCs regulate cell apoptosis by upregulating Caspase-8 expression, and downregulating PIPK1, PIPK3 and MLKL level, thereby alleviating the inflammation in AP.

scholarly journals Clinical Pattern and Management of Acute Pancreatitis – Our Experience

2014 ◽  
Vol 31 (3) ◽  
pp. 122-127
Author(s):  
MM Hasan ◽  
SZ Laila ◽  
MH Mamun
Keyword(s):  
Acute Pancreatitis ◽  
Gall Stone ◽  
Multiple Organ ◽  
High Serum ◽  
Military Hospital ◽  
Average Hospital ◽  
Systemic Involvement ◽  
Standard Management ◽  
Management Protocol ◽  
Upper Abdomen

Background: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas that may extend to local and distant extrapancreatic tissues. It is a life threatening disease that has many causes, few effective treatments, numerous serious complications, and an often unpredictable course. The objectives of this study are to develop our knowledge about presentation and diagnosis of acute pancreatitis, to assess the patient with acute pancreatitis accurately and to develop a standard management protocol. Methods: This observational study was carried out in Combined Military Hospital (CMH) Dhaka, CMH Momenshahi and CMH Ghatail during the period of June 2007 to December 2010. A total 25 patients of Acute Pancreatitis were studied retrospectively, evaluated and managed.Results: In this study 25 patients 19 (76%) were male (male : female = 3.17:1), age range 08 to 55 years, Mean age – 38.92 years. Maximum number of the patients fall into fourth and fifth decades. All patients presented with abdominal pain, specially in upper abdomen. Laboratory test revealed leucocytosis and high serum and urinary amylase, positive findings in Ultrasonogram and CT scan found in all patients. Gall stone was the leading cause 14 (56%). 20 (80%) patient developed some form of complications. 24 patients were treated conservatively. Average hospital stay was 15.52 days. Serious regional and systemic involvement in Acute Pancreatitis causes multiple organ or system failure. Conclusion: Early diagnosis and effective treatment can significantly reduce the morality and morbidity. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20977 J Bangladesh Coll Phys Surg 2013; 31: 122-127

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