Lipase or amylase for the diagnosis of acute pancreatitis?

Ismail, Ola Z.; Bhayana, Vipin

doi:10.1016/j.clinbiochem.2017.07.003

Cited by 162 publications

(127 citation statements)

References 60 publications

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“…Serum amylase levels of more than three times the upper limit of normal may be diagnostic; however, pancreatitis may exist with lower levels of amylase because, during a prolonged history, the amylase concentration may have normalised. Serum lipase is more sensitive and specific than amylase for diagnosis of acute pancreatitis . Early senior surgeon input is required if pancreatitis is suspected.…”

Section: Surgical Conditionsmentioning

confidence: 99%

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Surgical causes of acute abdominal pain in pregnancy

Woodhead

Nkwam

Caddick

et al. 2019

The Obstetric & Gynaecologis

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Key content Abdominal pain in pregnancy is common, with a differential diagnosis that can encompass obstetric, surgical and medical conditions. Presentation of common surgical problems can be atypical in pregnancy, potentially delaying diagnosis. Surgical causes of abdominal pain to consider in pregnancy include appendicitis, cholecystitis, bowel obstruction, ureteric obstruction, pancreatitis and aneurysm rupture, most commonly involving the splenic artery. The management of surgical conditions in pregnancy requires continuing evaluation and potential modification to balance the medical, surgical and obstetric challenges. Management of the pregnant woman with a surgical cause of abdominal pain requires collaborative, multispecialty practice to optimise care of the mother and baby. Learning objectives To highlight the differential diagnoses of abdominal pain in pregnancy. To develop a structured assessment process for pregnant women with abdominal pain. To update the obstetrician on the priorities of surgical management for abdominal pain in pregnancy. Ethical issues Evaluating the risks of surgical interventions on the mother and baby with the high potential for premature delivery.

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Section: Surgical Conditionsmentioning

confidence: 99%

“…Serum lipase is more sensitive and specific than amylase for diagnosis of acute pancreatitis. 33 Early senior surgeon input is required if pancreatitis is suspected. Surgical expertise can guide severity stratification and specific therapies.…”

Section: Pancreatitismentioning

confidence: 99%

Surgical causes of acute abdominal pain in pregnancy

Woodhead

Nkwam

Caddick

et al. 2019

The Obstetric & Gynaecologis

View full text Add to dashboard Cite

show abstract

“…Hyperamylasemia may occur as a result of renal failure, parotitis, ischemia, and intestinal obstruction, macroamylasemia, and the use of multiple medications. The lipase levels may increase spontaneously in bacterial peritonitis, intestinal ischemia, and esophagitis [40].…”

Section: Laboratory Testsmentioning

confidence: 99%

“…Laboratory Studies: Hemoconcentration and azotemia, or alteration in the levels of inflammatory markers (CRP > 150 mg/L, and levels of IL-6, IL-8, and IL-10) quantify the decrease in the intravascular volume for losses in the third space [40,49]. If the blood urea nitrogen (BUN), creatinine, and elevated hematocrit are not restored to normal range even after an aggressive resuscitation with fluids, then these are considered predictors of severe AP.…”

Section: Prediction Of Severity and Forecastmentioning

confidence: 99%

Review of Current Evidence in Acute Pancreatitis

Varley¹,

Rossi²,

Murray³

et al. 2019

obm hg

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Acute pancreatitis (AP), an inflammatory condition of the pancreas, is one of the most common ailments of the gastrointestinal system, which results in significant morbidity and mortality. The main etiological causes of AP include alcohol consumption, gallstones, hypertriglyceridemia, and biliary stones. The clinical signs and symptoms of AP and the diagnostic criteria for this disease have been well established. Multiple scoring systems are applied to predict the severity and prognosis of AP, and the associated mortality. The present review of the literature highlights the recent significant contributions in the areas of etiology, risk factors, epidemiology, diagnosis, complications, prognosis, and the latest modalities in the treatment, which could be beneficial in the management of AP.

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“…Serum lipase is a rapid and reliable laboratory test central to the diagnosis of acute pancreatitis. The addition of serum amylase to lipase has no significant value in improving the diagnostic sensitivity or specificity . Serum lipase has also a longer half‐life than amylase, which helps avoid any missed diagnosis in patients with a delayed presentation .…”

Section: Introductionmentioning

confidence: 99%

Clinical utility and economic burden of routine serum lipase determination in the Emergency Department

et al. 2019

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Background Serum lipase is a rapid and reliable laboratory test central to diagnosing acute pancreatitis (AP). Routine use in the emergency department (ED) setting for all cases of abdominal pain or as part of a standard laboratory biochemical profile may lead to unnecessary expenses. Aim To examine the utility of serum lipase determination at a tertiary care centre ED. Methods Retrospective cross‐sectional study of ED patients having serum lipase determination over a 12‐month period. Electronic medical records were reviewed for indication and interpretation leading to additional diagnostic imaging, specialist consultation, interventions or hospital admission. Results A total of 24 133 adult patients visited the ED during the study period: 4976 (20.6%) had serum lipase determination, 614 (12.4%) had abnormal lipase, 130 of which (21.1%) were above the diagnostic threshold for acutre pancreatitis (AP) (>3× ULN). A total of 75 patients had confirmed AP (0.3% of all adult ED visits). The positive and negative predictive values of serum lipase (>3× ULN) for AP were 43.6% and 99.6%, respectively. One thousand eight hundred and ninety patients (38.0%) had no abdominal pain on history or physical examination. In this group, the total charge associated with lipase determination was $51 030 with 251 (13.3%) elevated lipase values triggering cross‐sectional abdominal imaging in 61 (24.3%) patients and unwarranted gastroenterology consultation in three (1.2%) for an additional charge of $28 975. Conclusions Serum lipase is widely overutilised in the emergency setting resulting in unnecessary expenses and investigations. Evidence‐based review of clinical guidelines and more restrictive testing can result in substantial cost savings and improved patient care.

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Lipase or amylase for the diagnosis of acute pancreatitis?

Cited by 162 publications

References 60 publications

Surgical causes of acute abdominal pain in pregnancy

Surgical causes of acute abdominal pain in pregnancy

Review of Current Evidence in Acute Pancreatitis

Clinical utility and economic burden of routine serum lipase determination in the Emergency Department

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