scholarly journals Abdominal pain and a raised amylase? It’s not always pancreatitis…

2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
High Serum ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.

scholarly journals ―A Study on Serum Amylase Level And Prevalence of Acute Pancreatitis in Organophosphate Poisoning‖

2016 ◽  
Vol 15 (09) ◽  
pp. 71-98
Author(s):  
Dr Kumar Pankaj Shah ◽  
Dr M Rajkumar ◽  
Dr S Senthur Raja Pandian ◽  
Dr C Dharmaraj
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Organophosphate Poisoning ◽  
Amylase Level ◽  
Serum Amylase Level

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 Effect of hyperthermia on experimental acute pancreatitis

2006 ◽  
Vol 43 (4) ◽  
pp. 316-320 ◽  
Author(s):  
José Luiz Jesus de Almeida ◽  
José Jukemura ◽  
Sandra Nassa Sampietre ◽  
Rosely Antunes Patzina ◽  
José Eduardo Monteiro da Cunha ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Serum Levels ◽  
Post Treatment ◽  
Blue Dye ◽  
Amylase Level ◽  
Experimental Acute Pancreatitis ◽  
Serum Amylase Level ◽  
Group I ◽  
Serum Amylase Activity

BACKGROUD: Recent studies indicate that hyperthermia can change inflammatory mechanisms and protect experimental animals from deleterious effects of secretagogue-induced acute pancreatitis AIM: To evaluate the effects of hyperthermia post-treatment on cerulein-induced acute pancreatitis in rats METHODS: Twenty animals were divided in two groups: group I (n = 10), rats with cerulein-induced acute pancreatitis undergone hyperthermia, and group II (n = 10), animals with cerulein-induced acute pancreatitis that were kept normothermic. In all groups, amylase serum levels, histologic damage, vascular permeability and pancreatic water content were assessed. Acute pancreatitis was induced by administration of two cerulein injections (20 mcg/kg). A single dose of Evans' blue dye was administered along with the second dose of cerulein. All animals also received a subcutaneous injection of saline solution. After this process, animals undergone hyperthermia were heated in a cage with two 100 W lamps. Body temperature was increased to 39.5ºC and maintained at that level for 45 minutes. Normothermia rats were kept at room temperature in a second cage RESULTS: Control animals had typical edema, serum amylase activity and morphologic changes of this acute pancreatitis model. Hyperthermia post-treatment ameliorated the pancreatic edema, whereas the histologic damage and the serum amylase level remained unchanged CONCLUSIONS: The findings suggest a beneficial effect of the thermal stress on inflammatory edema in experimental acute pancreatitis.

scholarly journals Clinical significance of serum amylase and glucose level in organophosphorus poisoning

2019 ◽  
Vol 2 (3) ◽  
pp. 121-125
Author(s):  
Manoj Koirala ◽  
Bishow Raj Baral ◽  
Buddhisagar Lamichanne
Keyword(s):  
Acute Pancreatitis ◽  
Glucose Level ◽  
Serum Amylase ◽  
Serum Glucose ◽  
Clinical Severity ◽  
Serum Glucose Level ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Organophosphorus Poisoning ◽  
The Mean

Background: Organophosphorous (OP) poisoning is a common problem in country like Nepal where agriculture is the backbone of the economy. The primary mechanism of action is inhibition of acetylcholinesterase (ACHE). Organophosphorus poisoning is a possible cause of acute pancreatitis along with alternation of glucose metabolism. Materials and Method: This was a hospital based cross-sectional comparative study. The level of serum amylase and glucose were measured in thirty-eight OP poisoned patients at the time of admission, before discharge and were compared. Results: Amongst 38 patients, Majority had mild OP poisoning 27(71.1%) as per Peradeniya Organophosphorus Poisoning (POP) score whereas 9(23.7%) had moderate and 2(5.2%) had severe poisoning. The mean initial serum amylase level in patients with mild poisoning was 152±73.92 (IU/L)(p=0.000), in moderate poisoning was 213.38±69.39 (IU/L) (p=0.223) and in severe poisoning was 171.33±107.22(IU/L) (p=0.259). There was increase in serum amylase level in all patients with poisoning but level did not increase in proportion to increase with severity of POP score. The mean initial serum glucose level in mild poisoning was 132.48±37.73 (Mg/dl) (p=0.024), in moderate poisoning was 139±44.59 (Mg/dl) (p=0.033) and in severe poisoning was 174±23.38 (Mg/dl) (p=0.22). The serum glucose level increased as the severity of POP score increased. The serum amylase and glucose levels in recovering patients showed a tendency to decrease to their normal values. No patient had developed acute symptomatic pancreatitis. Conclusion: Serum amylase and glucose level were increased in all patients with OP poisoning but didn’t correlate with the clinical severity. Routine measurement of serum amylase in patients of OP poisoning has little value in the absence of clinical acute pancreatitis.

scholarly journals Correlation of serum amylase level with the severity of acute organophosphorus compounds poisoning

2021 ◽  
Vol 8 (3) ◽  
pp. 352
Author(s):  
Gunosindhu Paul ◽  
Mohammed Ruhul Kabir ◽  
A. B. M. Kamrul-Hasan ◽  
S. K. Kabir Ahammed ◽  
M. Enayet Hossain ◽  
...  
Keyword(s):  
Serum Amylase ◽  
Organophosphorus Compounds ◽  
Elevated Serum ◽  
Tertiary Hospital ◽  
Progressive Increase ◽  
Clinical Severity ◽  
Amylase Level ◽  
Cross Sectional ◽  
Serum Amylase Level ◽  
Mortality And Morbidity

Background: Organophosphorus (OP) poisoning is a common mode of suicidal poisoning in our country and is associated with significant mortality and morbidity. Serum amylase has shown a promising role in the assessment of the severity of OP poisoning. We conducted this study to see the association of serum amylase level with acute OP poisoning severity.Methods: This cross-sectional study was conducted among 150 patients admitted with acute OP poisoning to the inpatient department of medicine of a tertiary hospital in Bangladesh from July 2016 to June 2018. Peradeniya organophosphorus poisoning scale was used to detect clinical severity. Serum amylase was measured on the day of admission.Results: The patients' mean age was 23.68±6.80 years, and 65.3% were male. As assessed by the POP scale, 56.7%, 34.7%, and 8.7% of patients had mild, moderate, and severe grades of OP poisoning, respectively. The median serum amylase level was 103.50 (IQR 73.75-156.0) IU/l; 44.7% of the subjects had normal, and 53.3% had an elevated serum amylase. A progressive increase in serum amylase level was observed with the increasing severity of OP poisoning; 77.0 IU/l (IQR 58.0-97.0) in mild grade, 154.0 IU/l (IQR 125.25-162.5) in moderate grade, and 298.0 IU/l (IQR 289.5-305.0) in severe grade and the differences in the median amylase across the three groups were statistically significant (p<0.001). A significant positive correlation between serum amylase level and POP scale score (r=0.970; p<0.001) was also observed.Conclusions: Serum amylase level may be used as a readily available marker of the severity of acute OP poising in resource-poor settings.

scholarly journals Routine Measurement of Serum Amylase in Acute Abdomen

2014 ◽  
Vol 52 (196) ◽  
pp. 982-985 ◽  
Author(s):  
Roshan Ghimire ◽  
Anurag Singh Thapa ◽  
Dimindra Karki ◽  
Dipendra Kumar Shrestha
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
College Teaching ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Routine Measurement

Introduction: Acute abdominal pain is a common condition presenting to both the emergency department and surgical admission unit. Increase in serum amylase levels are found in much gastrointestinal pathology. Serum amylase level is consistently high in acute pancreatitis though high values are not pathognomonic of pancreatitis .The aim of this study to assess the level of serum amylase in various diseases presenting with acute abdominal pain and to evaluate the role of routine measurement of serum amylase in the screening of patient with acute abdominal pain for the diagnosis of acute pancreatitis in a prospective series. Methods: A prospective observational study was performed from 15th May 2014 – 15th Nov 2014 (6 months) at Department of Surgery of Kathmandu medical College Teaching Hospital; Kathmandu. All consecutive patients presented at emergency department and required admissions in surgical ward were included. A multivariate analysis was performed to assess the level of serum amylase in various diseases presenting with acute abdominal pain including acute pancreatitis. Results: Overall, 318 patients were included during a period of 6 months among them 48 patients were excluded. 34 cases (12.6 %) were diagnosed of acute pancreatitis. three cases (1.1%) of non pancreatic pathology with raised serum amylase level (> 1000 U\L). Conclusions: Routine assessment of serum amylase is helpful in excluding differential diagnosis of patient presenting with acute abdomen and this study identified serum amylase as a good screening tool if done in cases with clinical suspicion.  Keywords: acute abdominal pain; acute pancreatitis; serum amylase.

scholarly journals Patients with Non-diagnostic Hyperamylasaemia Must be Investigated and Managed as per Acute Pancreatitis

2012 ◽  
Vol 3 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Huw G Jones ◽  
Nicky Jardine ◽  
Jeremy Williamson ◽  
Malcolm CA Puntis ◽  
Gareth J Morris-Stiff
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Biliary Tree ◽  
University Hospital ◽  
Amylase Level ◽  
Median Serum ◽  
Drug History ◽  
Clinical Dilemma ◽  
Upper Abdominal

Objectives The identification of hyperamylasaemia insufficient to confidently diagnose acute pancreatitis in patients with epigastric pain poses a clinical dilemma. The aim of this study was to identify a cohort of such patients and review their presentation, investigation and outcome. Design Patients admitted through the emergency surgical intake during a 12-month period with serum amylase levels of 100–400 IU/L were identified and case notes reviewed to confirm those presenting with upper abdominal pain. Subsequent radiological and biochemical investigations were recorded. Participants A total of 25 patients with non-diagnostic hyperamylasaemia. Setting Ward patients in a University Hospital. Main outcome measures Amylase level, eventual diagnosis, drug history. Results Twenty-five patients were identified with a mean age of 46.7 years. The median serum amylase level was 230 IU/L (range 102–358 IU/L). Twenty-two patients underwent transabdominal ultrasound at presentation, with gallstones identified in nine cases. The remaining three had documented gallstones and were awaiting elective cholecystectomy. Of the 13 patients with no evidence of cholelithiasis, six were taking medications known to cause pancreatitis, seven patients underwent computed tomography (CT) scans that identified chronic pancreatitis in three, and were non-diagnostic in four cases. These four patients underwent endoscopic ultrasound (EUS) evaluation of the biliary tree identifying microlithiasis in one but no pathology in the remaining three cases. Conclusions Patients with hyperamylasaemia not diagnostic of pancreatitis should be carefully investigated, as gallstones will be identified in at least 50%. An accurate drug history is also invaluable.

scholarly journals Coronavirus Disease-19-associated Acute Pancreatitis: Report of Three Cases and Review of Case Reports

2021 ◽  
Vol 9 (C) ◽  
pp. 63-69
Author(s):  
Fahmi Yousef Khan ◽  
Theeb Osama Sulaiman ◽  
Arun Prabhakaran Nair ◽  
Mohamed Elmudathir Osman
Keyword(s):  
Acute Pancreatitis ◽  
Normal Limit ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Case Reports ◽  
Good Condition ◽  
Elevated Serum ◽  
Nausea And Vomiting ◽  
Severe Epigastric Pain ◽  
Pcr Test

BACKGROUND: Reports on coronavirus disease 2019 (COVID-19) associated with acute pancreatitis continue to emerge. In this series, we present three cases of acute pancreatitis associated with COVID-19 with no obvious etiology. CASE REPORTS: The first case was a 47-year-old man who presented with severe abdominal periumbilical pain, preceded by fever and dry cough. Based on a positive COVID-19 polymerase chain reaction (PCR) test and elevated serum amylase and lipase >3 times the upper normal limit, the diagnosis of COVID-19 and acute pancreatitis were established. The next case was a 57-year-old man with confirmed COVID-19 who developed severe epigastric pain radiating to the back and was associated with nausea and vomiting. His serum amylase and lipase were elevated >3 times the upper normal limit confirming the diagnosis of acute pancreatitis. The third case was a 31-year-old man who presented to the emergency department with a few hours of severe epigastric pain radiating to the back associated with nausea and vomiting. Two days before his presentation, he had a runny nose and fever. A combination of serum amylase and lipase elevation, >3 times the upper normal limits, and a positive COVID-19 PCR test were obtained concurrently, confirming the diagnosis of COVID-19 associated acute pancreatitis. All patients were admitted to the Mesaieed Hospital COVID-19 facility and received treatment for COVID-19 according to our local guidelines, while acute pancreatitis was treated conservatively. All three patients were discharged in good condition. CONCLUSION: This case series suggests a possible correlation between COVID-19 and acute pancreatitis.

scholarly journals Comparison of ultrasound and serum amylase in the diagnosis of acute pancreatitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4030
Author(s):  
Manoharan G. V. ◽  
Maharaja P.
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Serum Amylase ◽  
Imaging Modality ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Amylase Level ◽  
Age Group ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: Acute pancreatitis is an inflammatory disease of the pancreas. Though, severe acute pancreatitis constitutes 15-20% of all cases of pancreatitis, in recent times, mortality rate of severe acute pancreatitis has reduced from 30-80% to 15-20%. Ultrasound is the first imaging modality in most centres for the preliminary screening of an acute abdomen.Methods: In this prospective study between October 2017 to March 2019, 113 patients with clinical signs and symptoms of acute pancreatitis were screened with an ultrasonogram of the abdomen and serum amylase in the emergency room. Patients also underwent a complete physical exam.Results: In our study 38.9% of patients were in the age group of 45-55 years, 25% in the 35-45 age group and 20.4% in the 55 to 70 age group. 92.9% of the patients were men. 89.4% of the participants had a history of alcoholism. Only 37.2% of the participants who were clinically positive for acute pancreatitis, also showed USG findings for acute pancreatitis while 69% of the clinically positive patients showed serum amylase level positive for acute pancreatitis.Conclusions: Ultrasonogram though cheap and easily available is not ideal for the diagnosis of acute pancreatitis. As shown in the study serum amylase is able to detect nearly twice as many cases of pancreatitis compared to ultrasonogram. The sensitivity and specificity of ultrasonography to detect acute pancreatitis is too low to use as a diagnostic test but it is a valuable tool in the evaluation of an acute abdomen.

Electrolyte and other physiological abnormalities in patients with bulimia

1983 ◽  
Vol 13 (2) ◽  
pp. 273-278 ◽  
Author(s):  
James E. Mitchell ◽  
Richard L. Pyle ◽  
Elke D. Eckert ◽  
Dorothy Hatsukami ◽  
Richard Lentz
Keyword(s):  
Eating Disorder ◽  
Metabolic Alkalosis ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Screening Tests ◽  
Amylase Level ◽  
Serum Electrolyte ◽  
Serum Amylase Level ◽  
Physiological Abnormalities ◽  
Electrolyte Abnormalities

SYNOPSISThe frequencies of various forms of eating-related behaviour (such as vomiting and laxative abuse) are reported for a series of non-anorectic bulimia patients seen for evaluation in an eating disorders clinic. The results of serum electrolyte, glucose and other screening tests in these patients are presented. Electrolyte abnormalities were found in 82 of the 168 patients (48·8%) who were diagnosed as having either bulimia or atypical eating disorder. The most common abnormality was metabolic alkalosis (27·4%); hypochloremia (23·8%) and hypokalemia (13·7%) were also commonly seen. No significant blood sugar abnormalities were encountered. An elevated serum amylase level was found to be associated with frequent binge-eating and vomiting behaviour. The pathophysiology of electrolyte abnormalities in this patient group is briefly reviewed.

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