Title: Role of Serum Amylase and Lipase Levels in the Classification of Acute Pancreatitis According to Revised Atlanta Classification
Authors: Dr Ajay Alex, Dr Josey Verghese, Dr Saji Kumar, Dr K.B.Salim
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.177
Abstract
Introduction: Revised Atlanta classification proposed the use of morphologic CECT criteria to diagnose the specific type of acute pancreatitis into acute interstitial oedematous pancreatitis (IEP) or acute necrotizing pancreatitis. The total serum amylase test is most frequently ordered to diagnose acute pancreatitis, because it can be measured quickly and cheaply. In acute pancreatitis, the serum amylase concentration is usually more than 2 to 3 times the upper limit of normal. Lipase is considered as the most sensitive and specific marker for acute pancreatitis currently used in clinical practice. The aim of this study was to evaluate for any correlation of radiological imaging features in acute pancreatitis with pancreatic enzyme levels.
Materials and Methods: This was a descriptive study involving 67 study subjects suspected to have acute pancreatitis who underwent CECT Abdomen in the department from January 2015 to June 2016. Imaging findings were defined as per Revised Atlanta classification in addition to obtaining serum amylase and lipase values. Data collected were analysed using statistical tools.
Results: Mean values for serum amylase for IEP was 1127.39 and 1572.74 for necrotising pancreatitis. Mean values for serum lipase for IEP was 1390.39 and 2401.03 for necrotising pancreatitis. Independent sample t test was done to compare mean values of serum pancreatic enzyme levels in specific type of pancreatitis. Though the mean values were found to be higher for necrotising pancreatitis, no significant association (p value < 0.05) was found between the enzyme level and the type of pancreatitis.
Conclusion: Pancreatic enzyme evaluation was observed to aid in diagnosing acute pancreatitis; however their levels were not significant to predict the type of pancreatitis as defined by Revised Atlanta classification.
Keywords-acute pancreatitis, amylase, lipase, Revised Atlanta classification, computed tomography.
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