Biochemical tests (serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, alkaline phosphatase, gammaglutamyltranspeptidase, bilirubin, and serum amylase) were performed upon admission in 84 patients with suspected (36) or proven (48) acute pancreatitis at the time of the first episode of acute abdominal pain suspected clinically as acute pancreatitis. These parameters all increased significantly more in patients with gallstone pancreatitis. Among them, the SGPT was the most discriminant test between biliary and nonbiliary pancreatitis. The positive predictive value of SGPT was 92%, when the cutoff point was chosen at twice the upper limit of normal. In patients with increased SGPT, a SGOT-SGPT ratio less than 1 is the rule (88%) for those with gallstone pancreatitis. This enzymatic determination allowed us to select more accurately the patients suitable for morphological procedures to confirm the biliary origin of the pancreatitis.

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The aims of the study were to determine the nature of the procoagulant activity present in the ascitic fluid and the means to inhibit the thrombotic complications appearing after peritoneovenous shunting. In a prospective study, 10 ascitic fluids (5 exsudates, 5 transsudates) were studied. The procoagulant activity was defined as the capacity of ascitic fluid to shorten the recalcification time of a control plasma.Our results showed :1. All the ascitic fluids exhibited a procoagulant activity.2. The procoagulant activity of the cellular fraction was related to the presence of platelet factor 3 (PF3) and polymorphonuclear elastase and may be inhibited by the combination of inhibitors of PF3 (phospholipase A inhibitor calbio-chem) and elastase antibody.3. The procoagulant activity of the free cellular fraction was related to the presence of thrombin, factor Xa, PF3 and tissular thromboplastin, and may be inhibited by a combination of Antithrombin III, phospholipase A and Diisopropyl-fluorophosphate.Conclusion :1. The important procoagulant activity of ascitic fluid is present in both cellular and acellular fractions and is related to the presence of different coagulation activators (PF3, elastase, Xa, thrombin, tissular thromboplastin).2. The administration of a combination of AT III and phospholipase A in the ascitic fluid before the contact with the whole blood allows to inhibit the procoagulant activity of ascitic fluid and could prevent the thrombotic complications appearing after peritoneovenous shunt.

Fibrinogen degradation products (FDP), Ethanol gel test (EGT), citrated whole blood thrombo elastogram (TEG) and its several parameters (r, k, am, IFT), Raby’s transfer test (RTT) and Wu’s circulating platelet’s aggregates (CPA) were studied in 52 healthy volunteers acting as normal controls, in 205 consecutive patients admitted in a general hospital for various non-thrombotic pathological situations (group 1), and in 14 consecutive patients admitted for deep vein thrombosis, pulmonary embolism or acute coronary insufficiency (group 2).In conclusion : 1. TEG and CPA are of doubtful help in separating thrombo-embolic situations from other pathological conditions.2. EGT disclosed a better specificity (6% false positive) but its sensitivity is poor (64% false negative).3. Good specificity altogether with sensitivity in diagnosing thrombo-embolic situations is better achieved by FDP (11% false positive and 43% false negative) and even better by RTT (11% false positive and 29% false negative).

Citrated whole blood thrombo-elastogram (TEG) and its several parameters (r, k, am, IPT), Ethanol gel test (EGT), Fibrinogen degradation products (FDP) and Raby’s transfer test (RTT) were studied in 52 healthy volunteers acting as normal controls, in 211 consecutive patients admitted in a general hospital for non thrombotic pathologies (group 1), in 59 consecutive patients admitted for deep vein thrombosis (group 2) and in 45 consecutive patients addmitted for pulmonary thrombo embolism, confirmed at scintigraphy (group 3).In conclusion: l. TEG (r, k, am, IPT) offers little help in the early diagnosis of deep vein thrombosis as well as pulmonary thrombo embolism. 2. EGT although offering a high specificity (6.6% false positive), lacks of sensitivity for the diagnosis of deep vein thrombosis (56.6% false negative). 3. RTT appears as a highly sensitive detector of deep vein thrombosis (positive in 96.6% of cases) and of pulmonary embolism (positive in 97.7% of cases) as well as reasonably specific (12.3% false positive tests). 4. Negativity of FDP and RTT appears as a strong argument against the diagnosis of thrombotic disease.