Comparison of ultrasound and serum amylase in the diagnosis of acute pancreatitis

Authors

  • Manoharan G. V. Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India
  • Maharaja P. Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India

DOI:

https://doi.org/10.18203/2349-2902.isj20205352

Keywords:

Acute pancreatitis, Ultrasound, Serum amylase, Diagnostic accuracy

Abstract

Background: Acute pancreatitis is an inflammatory disease of the pancreas. Though, severe acute pancreatitis constitutes 15-20% of all cases of pancreatitis, in recent times, mortality rate of severe acute pancreatitis has reduced from 30-80% to 15-20%. Ultrasound is the first imaging modality in most centres for the preliminary screening of an acute abdomen.

Methods: In this prospective study between October 2017 to March 2019, 113 patients with clinical signs and symptoms of acute pancreatitis were screened with an ultrasonogram of the abdomen and serum amylase in the emergency room. Patients also underwent a complete physical exam.

Results: In our study 38.9% of patients were in the age group of 45-55 years, 25% in the 35-45 age group and 20.4% in the 55 to 70 age group. 92.9% of the patients were men. 89.4% of the participants had a history of alcoholism. Only 37.2% of the participants who were clinically positive for acute pancreatitis, also showed USG findings for acute pancreatitis while 69% of the clinically positive patients showed serum amylase level positive for acute pancreatitis.

Conclusions: Ultrasonogram though cheap and easily available is not ideal for the diagnosis of acute pancreatitis. As shown in the study serum amylase is able to detect nearly twice as many cases of pancreatitis compared to ultrasonogram. The sensitivity and specificity of ultrasonography to detect acute pancreatitis is too low to use as a diagnostic test but it is a valuable tool in the evaluation of an acute abdomen.

Author Biographies

Manoharan G. V., Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India

Professor, Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India

Maharaja P., Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India

Assistant Professor, Department of General Surgery, Sri Manakula Vinayakar Medical College and Hospital, Pondicherry, India

References

Beger HG, Rau B, Mayer J, Pralle U. Natural course of acute pancreatitis. World J Surg. 1997; 21:130-5.

McWilliams O, Maher MM. Image of acute pancreatitis. AJR Am J Roentgenol. 2011;197: W221-5.

Spanier BW, Dijkgraaf MG, Bruno MJ. Epidemiology, aetiology and outcome of acute and chronic pancreatitis: an update. Best Pract Res Clin Gastroenterol. 2008;22:45

Bankes PA, Freeman ML. Practice parameters committee of the american college of gastroenterology. practice guidelines in acute pancreatitis. Am J Gastroenteral. 2006;101: 2379-400.

Whitcomb DC, Clinical practice, acute pancreatitis. N Engl J Med. 2006;354:2142-50.

Jeffrey RB. Sonography in acute pancreatitis. Radiol Clin North Am. 1989;27:5-17.

Scaglione M, Casciani E, Pinto A, Andreoli C, De Vargas M, Gualdi GF. Imaging assessment of acute pancreatitis: a review. Semin Ultrasound CT MR. 2008;29:322-40.

Silverstein W, Isikoff MB, Hill MC, Barkin J. Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography. AJR Am J Roentgenol. 1981;137:497-502.

Zerem D, Zerem O, Zerem E. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis. Euroasian J Hepatogastroenterol. 2017;7(1):1-5.

Bhimal RK. A prospective study of clinical, biochemical and radiological features in pancreatitis. Int J Adv Med. 2017;4(5):1386-93.

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Published

2020-11-27

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Original Research Articles