Role of Serum Amylase and Serum Lipase for the Diagnosis of Acute Pancreatitis: A Comparative Study

Diagnosis of Acute Pancreatitis

Abstract

Background: Acute pancreatitis is among the most common diseases required surgery in emergency throughout the world. There is still lake of any gold standard for acute pancreatitis diagnosis. Since 1920 serum amylase has been evaluated for the diagnosis of acute pancreatitis. Sensitivity of serum lipase has been reported less than 85%. Different studies recorded low sensitivity up to 63% for serum amylase compare to high sensitivity up to 99% for serum lipase, whereas, approximately equal specificity serum amylase and lipase. Therefore, the present study was planned to assess the diagnostic accuracy of serum amylase and lipase individually. Moreover, the current study would try to find the single marker for acute pancreatitis diagnosis especially in smaller centres where facilities of diagnosis are limited. Subjects and Methods: Total 498 patients with pain in abdomen were included in the study. Among these patients 102 patients were diagnosed as acute pancreatitis patients. The diagnosis of acute pancreatitis was made according to following criteria: i) Characteristic of abdominal pain. ii) Three times increase of serum levels of amylase or lipase, or both. iii) Computed tomography findings. Results: Results of the current study showed that among 498 patients with abdomen pain 102 patients were diagnosed for acute pancreatitis on the basis of CT scan. Among these acute pancreatitis patients all 58 patients showed high level of both serum amylase and lipase; all 102 patients showed higher level of serum lipase while, 72 patients recorded high serum amylase level. Conclusion: Findings of the present study suggested that diagnostic accuracy of both serum amylase and serum lipase was excellent for the acute pancreatitis. Nevertheless, serum lipase has as an edge in accuracy over serum amylase for the diagnosis of acute pancreatitis. Therefore, we strongly suggest that measurement of serum lipase might be helpful in the diagnosis of acute pancreatitis in smaller centres where diagnostic facilities are limited.