Biochemical and Radiological Parameters in Acute Pancreatitis among Patients from a Rural Community of South India

Abstract

Background and Purpose: Acute pancreatitis is one of the major causes of acute abdominal pain that requires hospital admission worldwide. Our objective was to find the proportion of acute pancreatitis in acute abdomen cases among the rural population and to assess pancreatic enzymes (lipase and amylase) for the severity of acute pancreatitis. By doing so, we can establish the importance of a single enzymatic marker in acute pancreatitis. Methods: A retrospective and observational study was undertaken on men and women of all age groups admitted over 1 year with acute pancreatitis at a rural tertiary care hospital located at the tristate junction of South India. Pancreatic enzymes (lipase and amylase) were compared based on the grading and severity of pancreatitis according to the modified computed tomography severity index. Results: The proportion of acute pancreatitis was 40% among all acute abdomen cases. Most patients with acute pancreatitis were chronic alcoholic men (62.5%). The common finding in abdominal ultrasonography (USG) was the enlargement of the pancreas (97.5%). There was an overall rise in serum lipase levels in all acute pancreatitis patients, especially in alcoholic patients. The median lipase levels were higher in severe acute pancreatitis than in moderate acute pancreatitis, with P = 0.006. In comparison, there was no significant difference in amylase values between them. Conclusions: In this study, we could conclude that acute pancreatitis is one of the major emergency conditions in this region of rural India, especially among men who are chronic alcoholics. The enlargement of the pancreas was the most frequent finding in USG among these patients. We suggest that a single pancreatic marker (serum lipase) in acute pancreatitis can be cost-effective. Moreover, serum lipase can also be a marker for assessing the severity of acute pancreatitis.

The relationship of biochemical parameters and radiological parameters in the evaluation of the clinical severity of acute pancreatitis in the emergency department – a retrospective analysis

“…No correlation was reported between the severity of AP determined by CECT and the amylase level. 13 Contrary to that study, we found a weak positive correlation between amylase and CTSI.…”

“…In the literature, there are studies comparing amylase, lipase, CRP, and procalcitonin parameters separately with CTSI. [11][12][13] However, we found no study that evaluated all these four parameters together with CTSI. Therefore, in the current study, we aimed to evaluate the correlation of amylase, lipase, CRP, and procalcitonin parameters with CTSI in AP.…”

A randomized controlled trial of acute pancreatitis in Thanjavur medical college: an institutional experience

“…The enlarged pancreas observed on USG can serve as a cost-effective marker for acute pancreatitis, and serum lipase can help determine the severity of the condition. 10…”

“…In patients with mild acute pancreatitis, many studies have found that the use of ERAS methods could hasten recovery. 10 The purpose and the goal of the current study is to use compare the effects of an improved recovery strategy as the standard of care and basic strategy to assess the outcomes of individuals who had mild and moderate acute pancreatitis.…”