The predictive role of amylase and lipase levels on pancreas injury diagnosis in patients with blunt abdominal trauma

Abstract

ObjectivesDespite the low incidence of pancreatic injury in the abdominal blunt trauma (BTA), its early diagnosis is very important; since pancreatic injury is associated with high rates of morbidity and mortality. However, due to the high association of pancreatic injury with injury of other abdominal organs, its diagnosis may be delayed and complicated. The use of imaging modalities is also subject to limitations for reasons such as cost, unavailability, and harmfulness. Consequently, the present study aimed to investigate the predictive role of amylase and lipase enzyme levels in the final diagnosis of pancreatic injury in patients with BTA.MethodsIn a prospective diagnostic study, 384 patients with BTA referring to Imam Khomeini hospital of Sari (north of Iran) were enrolled according to the inclusion and exclusion criteria. Initial patient data including age and sex were recorded. Blood samples were analyzed in the laboratory to measure complete blood count (CBC), amylase and lipase enzyme levels. Patients were followed up during hospitalization and focal ultrasound for abdominal trauma (FAST), CT-Scan and laparotomy results were recorded. Finally, the data was analyzed using SPSS version 22.ResultsThe level of amylase enzyme was significantly higher in males (p = 0.04), but the level of lipase enzyme was not significantly different between two genders (p > 0.05). The most common symptoms and signs in patients were pain, tenderness, and hematoma, respectively. The frequency of pancreatic injury in all patients with blunt abdominal trauma was 7.5% based of FAST, 7% based on CT-Scan and 12.4% based on laparotomy. Comparison of laboratory findings based on FAST, CT-Scan and laparotomy results showed that the level of amylase and lipase enzymes in patients with internal organ and pancreatic damage were higher than in patients without internal organ injury (p < 0.05). But based on FAST results; patients with pancreatic injury and injury of other organs had no significant difference (p > 0.05). However, comparison of laboratory findings based on CT-Scan and laparotomy results showed a significant increase in the level of amylase and lipase enzymes in patients with pancreatic trauma compared to patients with injury of other organs (p < 0.001).ConclusionsThe results of this study showed that pancreatic injury in blunt trauma is associated with a significant increase in levels of amylase and lipase enzymes. In addition, an increase in levels of amylase and lipase enzymes is associated with internal organ damage. Serum amylase and lipase levels can be used as useful biomarkers to decide whether to perform CT-Scan or laparotomy.

COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus

“…Different studies reported that COVID-19-induced PI is diagnosed through detailed medical history, physical examination, and ultrasonography imaging with elevation in serum lipase levels. However, in severe cases, abdominal CT scan imaging is recommended (25). In COVID-19, PI may occur either by direct invasion of SARS-CoV-2 or indirectly through the induction of CS (26).…”

La variación de hábitos alimentarios ocasionados por la COVID-19. ¿Llegaron para quedarse?

“…Esto concuerda con un estudio de 134 pacientes, 43 (32 %) presentaban lesión esplénica, 28 (20.8 %) hepática, 6 (4.4 %) lesiones intestinales, de los cuales 4 (2.9 %) correspondían a intestino delgado y 2 (1.4 %) al intestino grueso (Parra-Romero et al, 2019) (Rao et al, 2018). Hay autores que sugieren que después del bazo y el hígado se afectan en mayor frecuencia los riñones, seguidos del páncreas (Hosseininejad et al, 2020). Otros estudios que comparten la idea que la lesión renal posee mayor frecuencia por sobre la intestinal (He et al, 2020) (Belman & Toka, 2019.…”

“…Existe debate sobre la validez de las concentraciones de amilasa y lipasa en el contexto de trauma abdominal contuso. Si bien es cierto, puede existir niveles elevados de estas enzimas en lesiones de lengua, esófago, duodeno, intestino delgado, hígado, hemorragia intracraneal o pacientes críticos en unidades de terapia intensiva; existen estudios que demuestran su valor en detectar el trauma pancreático agudo (Hosseininejad et al, 2020).…”

Trauma Abdominal Cerrado en Adultos; Opciones diagnósticas

“…Esto concuerda con un estudio de 134 pacientes, 43 (32 %) presentaban lesión esplénica, 28 (20.8 %) hepática, 6 (4.4 %) lesiones intestinales, de los cuales 4 (2.9 %) correspondían a intestino delgado y 2 (1.4 %) al intestino grueso (Parra-Romero et al, 2019) (Rao et al, 2018). Hay autores que sugieren que después del bazo y el hígado se afectan en mayor frecuencia los riñones, seguidos del páncreas (Hosseininejad et al, 2020). Otros estudios que comparten la idea que la lesión renal posee mayor frecuencia por sobre la intestinal (He et al, 2020) (Belman & Toka, 2019).…”